Tonsillectomy is a standard procedure for children, and with the right pain management, your child’s recovery can be smooth and comfortable. The key to adequate pain control is regular pain relief on schedule – by the clock! Setting reminders and following a structured approach to minimise discomfort is essential.

Managing Pain After Tonsillectomy

1. Regular Pain Relief (Panadol and Oxynorm)
   • The basic plan involves administering Panadol every 4 hours during the daytime and Oxynorm at bedtime. Set your mobile phone to remind you to give pain relief every 4 hours to ensure your child remains comfortable.
   • If Panadol is not enough, Oxynorm can also be given during the daytime, but each dose of Oxynorm must be spaced at least 4 hours apart.
2. Panadol Dosage
   Panadol is dosed at 15 mg/kg and should be given 4 times a day. However, if necessary, you can extend this to 5 doses a day (e.g., if your child wakes up with pain during the night, around 2 a.m.).
3. Alternative Forms of Pain Relief
   If your child refuses oral Panadol, Panadol suppositories can be used as an alternative to ensure continued pain relief.
4. Medications to Avoid
   Do Not Use Nurofen, Fenpaed, or Fish Oil for 2 weeks before and after the surgery, as these medications can promote bleeding and should be avoided during recovery.
5. Caution with Codeine
   Codeine is a potent pain reliever but can sometimes cause side effects such as vomiting and constipation. Be aware of these potential issues if codeine is administered.
6. Timing of Pain Relief
   Pain relief can take 15 to 20 minutes to be absorbed, so you may need to wait for this period before giving your child breakfast or encouraging other activities.

Keeping Your Child Comfortable

1. Hydration
   Keeping your child well-hydrated is essential. Encourage them to sip water regularly. Cold fluids, such as ice water or icy poles, can also soothe the throat and help reduce discomfort.
2. Diet
   Offer soft foods like jelly, ice cream, yoghurt, or soups that are easy to swallow and won’t irritate the throat. Avoid acidic, spicy, or hard foods that may cause pain or discomfort. Acidic foods include orange juice, raw tomato and sometimes bananas.
3. Rest and Recovery
   Ensure your child gets plenty of rest during the first week after surgery. Physical activity should be limited to allow proper healing. Keep your child home from school and avoid strenuous activities.
4. Head Elevation Sleeping with the head slightly elevated can help reduce swelling and ease discomfort. A propped-up pillow may make your child more comfortable during the healing process.

Bleeding and Other Symptoms to Watch For

1. Post-Surgery Bleeding
   A small amount of bleeding is expected in the first few hours after surgery. However, if your child experiences persistent or significant bleeding, contact your surgeon or the hospital immediately. Please keep your child calm and encourage them to avoid coughing or clearing their throat, as this can increase the risk of bleeding.
2. Nausea and Vomiting
   Nausea or vomiting can occur after surgery, often due to the anaesthesia. This should subside within a day or two. If vomiting persists, contact your surgeon or the hospital.

Post-Surgery Recovery Tips

1. Pain-Free Eating
   Encourage your child to eat small meals and drink plenty of fluids, even if they are not feeling hungry. Keeping the throat moist will aid in healing and reduce pain during recovery.
2. Ice cream
   The brain senses temperature before pain so that is why ice cream is such a favourite after tonsillectomy!

Frequently Asked Questions About Pain relief for kids after tonsillectomy