Postoperative recovery in children after outpatient ENT surgery

Objective: To provide a comprehensive description of postoperative recovery after routine outpatient ENT procedures in children and to compare parental estimations to the child’s self-reported ratings of postoperative pain. Methods: For 14 days after surgery, we monitored pain, nausea or vomiting, problems with eating and fluid intake, sleep disturbances, behavioral changes, emotional impact, other types of discomfort, rehospitalization, and duration to full recovery, based on diary entries and telephone calls. Results: 69 children and their parents participated. After inserting ventilation tubes, the average recovery time was 4.6 days. Symptoms were most intense during the first three days. Participants mainly reported pain, behavioral changes, and emotional impact. After more extensive ENT surgery (adenoidectomy and/or tonsillectomy, with or without insertion of ventilation tubes), the average recovery time was 6.2 days, and pain was more severe and longer-lasting. Apart from nausea or vomiting during the first three days, participants frequently reported behavioral changes, emotional impact, and sleep disturbances. Problems with eating and fluid intake were most prevalent. Pain scores reported by parents differed from the scores reported by their children; parents both underestimated and overestimated their child’s pain. Conclusion: This study provided descriptions of postoperative recovery after outpatient ENT surgery in children. This information is indispensable for preparing the child and parents and for ensuring accurate followup. Recovery varied with the type of surgery. Mainly, postoperative discomfort was most severe after adenoidectomy and/or tonsillectomy. Parents tended to give inaccurate estimates of their child’s pain. Self-reports from children should be considered the gold standard.