What happens after the operation?

The throat will be painful after the surgery, and therefore it’s important to follow the prescription and take painkillers regularly. It is normal after tonsillectomy for the intensity of the pain to increase 3-5 days after surgery and then decrease. It is less painful when only part of the tonsils have been removed.

The pain is worse in the morning; this is true for several reasons. Partially because the child has a dry throat from not swallowing anything during the night, but also because it’s been a long time since the last pain medicine was taken.

It’s more comfortable to sleep at night with a slightly higher support under the head than normal; the swelling of the mucous membrane surrounding the area operated is diminished and the pain is therefore reduced. The tongue may feel uncomfortable for the first few days after the operation, because the tongue has been pushed down with a special instrument during the surgery to make it easier to get to the tonsils. It will usually feels better if you can get the child to move his/her tongue, therefore it’s good to get them to eat and drink. Also, the ears may ache without there being an ear infection. Chewing gum can sometimes alleviate the ache.

Pain relief

After the operation, it’s very important to take painkillers (medicines to stop pain). These must be taken according to the doctor’s instructions and at regular times for them to have the best effect. Get the child to eat approximately 30–60 minutes after he/she has taken the painkiller, since that is when the effect of the painkiller is at its best. Healthy children receive paracetamol (for example, Alvedon, Panodil) together with anti-inflammatory analgesics (for example Ipren, Diklofenak) as basic pain reliever. Additional or different medicine may be prescribed by the doctor.

Buy the painkillers in advance so that you already have them available when you and your child return home after the operation. You can buy Paracetamol and anti-inflammatory analgesics without a prescription from the chemist/drugstore and in many shops. You may need a prescription to buy other recommended painkillers; you’ll be given advice and any necessary prescriptions by the doctor in charge for your child’s treatment.


Information about pain management for your child

Do you need information about pain mangement for your child, how you assess your child´s pain, clues as to whether your child experinece pain or do you want more about pain-relieving medication and doses?


Nausea

Nausea and vomiting are common, especially during the first evening after the operation. It is not unusual that old blood (dark looking) appears in the vomit, this is due to the fact that blood often cumulate into the stomach during surgery. The nausea usually disappears a day after the surgery.

Food and drink

It’s important to encourage your child to eat and drink normally. If the throat is dry, the child is likely to feel more pain. Give the child what he/she wishes to eat. Liquid and soft food is usually best just after the day of the operation. Hot food and food that can scrape the throat (for example crisp bread and hard apples) be avoided for the first days.

How long does my child need to stay at home?

The time that the child needs to stay at home varies. When only the enlarged parts of the tonsils have been removed, the child should be home for at least 4 days. When both tonsils have been removed completely, the child should be home for at least 8 days.

Bed rest isn’t necessary. It’s good for the child to be up under calm conditions even during the first few days, and there’s no reason to prevent the child from going outside if the child feels up to it. If at all possible, avoid being with people who have a cold.

The child should not be allowed to do things requiring heavy physical effort during the 14 days that are normally required for the throat to heal completely, e.g. wrestling, jumping on a trampoline, riding bicycles, jogging, aerobics, etc. Please avoid flying and foreign travel for 3 weeks after the operation.

Follow-up

Most of the times there is no follow up scheduled as per routine. In the event of any complications (bleeding, persistent pain, high temperature), please see under the tab “Important”. All tonsil operations in Sweden are monitored via the National Tonsil Surgery Register in Sweden. The Quality Registry helps us to improve health care.

You’ll receive two questionnaires, the first after thirty days and the second after six months. Quenstionnaries 30 days after the operation, important information is obtained  about, for example, complications after your child´s operation such as post-operative bleeding, infection and pain and how adequate the patient information was. Six months after the operation, the patient is asked to answer a questionnaire, where the degree of symptom relief is requested.

It’s of great importance to receive your answers, even if you haven’t experienced any discomfort. It’s important that you answer both questionnaires!
30 days after the operation, information is obtained from the patient about, for example, complications such as post-operative bleeding, infection and pain and how adequate the patient information was. Six months after the operation, the patient is asked to answer a questionnaire, where the degree of symptom relief is requested.

After the operation, it’s a good idea to talk about how things were at the hospital, if it was tough and, if so, why.

The child can explain through drawing a picture. Preferably use the stories on www.tonsilloperation.se or www.anaesthesiaweb.com

In addition to receiving painkillers, it’s important that the child receives more attention than usual.

By reading, playing games and watching TV together, the child is distracted from the pain in their throat