ABSTRACT
Children undergoing tonsillectomy remain at risk for postoperative pain, respiratory depression, and postoperative nausea and vomiting (PONV), presenting unique challenges for the postanesthesia nurse. This prospective, observational study examined the relationships between and factors contributing to these outcomes in 102 children after tonsillectomy. All children received an intraoperative opioid and one or more antiemetics. The majority (67%) experienced moderate to severe pain, 27% experienced a respiratory event, and 7% had PONV. Children with moderate to severe pain received similar intraoperative opioid dosages, increased postoperative opioids (P < 0.05), and had longer PACU stays (P < 0.05) compared to those with no to mild pain. Respiratory events were not associated with age, sleep-disordered breathing, or opioid use. This study suggests that children undergoing tonsillectomy experience significant pain and respiratory events. Further study examining nonopioid treatments are warranted to determine the best practices for this high-risk group of children.
Subject(s)
Adenoidectomy , Tonsillectomy , Adolescent , Analgesics, Opioid/administration & dosage , Antiemetics/administration & dosage , Child , Child, Preschool , Female , Humans , Intraoperative Care , Male , Pain, Postoperative/prevention & control , Postoperative Nausea and Vomiting/prevention & control , Postoperative PeriodABSTRACT
This prospective, randomized study compared the incidence and duration of postanesthetic agitation in children whose parents were present or absent during emergence from anesthesia. Findings demonstrated that there was no difference in agitation between groups; however, more parents who were present believed they were present at "the right time," in contrast to those reunited later, who more often said they arrived "too late." Furthermore, these parents were comfortable in the setting and reported a high degree of helpfulness in comforting their child. Findings from this study suggest that although parental presence at emergence did not decrease agitation in young children, there was significant psychosocial benefit to the parents. Perioperative and perianesthesia nurses should consider these potential benefits when planning reunion of parents with their children after surgery.
