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Tonsillectomy: Pain management at home

Pain or discomfort after a tonsillectomy (with or without an adnoidectomy) is a common concern for parents and children. This sheet is intended to:

  • Reduce concern and stress related to pain management at home.
  • Give comfort tips to use at home.
  • Explain normal versus abnormal experiences in the postoperative period.

What is common after surgery?

A fever less than 102° F for 3 to 4 days after surgery is normal. During the first 10 to 14 days it is common to have:

  • Pain or discomfort.
  • Increased pain in the mornings.
  • Bad breath.
  • White areas where the tonsils used to be is normal and not a sign of infection.
  • Increase in pain starting about 7 days after surgery as the formed scabs start to come off.
  • Ear pain (this is referred pain following surgery).
  • Neck pain/skull base (this is referred pain following surgery).
  • Snoring may continue after surgery as your child continues to heal.

Comfort tips

  • Have your child eat or drink cold foods and fluids (2-3 ounces per hour). Staying hydrated is associated with less pain.
  • Your child may be more willing to eat or drink 30 minutes after pain medicine.
  • Sleep or rest
  • Distraction: movies, video games, music, puzzles, coloring, massage.
  • Hold or lie down with your child.
  • Ice/cold pack: Place on neck or forehead. Always place a towel between the ice pack and your child's skin.
  • Heating pad for ear pain.
  • Chewing can help alleviate ear pain. Encourage child to open mouth to exercise the jaw.
  • Cool humidifier to decrease throat dryness and pain. Be sure to change the water at least once a day.
  • Elevate the child's head with 2 pillows when lying down to keep the airway more open and allow easier breathing.

Tips for giving pain medicine

  • Do not wait until your child is in pain. Instead, give pain medicine on a regular schedule. See the chart on page 3 to help keep track of your child's medicines.
  • When using a syringe to squirt liquid medicines into your child's mouth, aim the medicine along the inside of the cheek instead of the middle of the mouth. Your child will be less likely to gag and will have a more difficult time spitting out the medicine.
  • Talk to your pharmacist about flavoring certain medications to make the taste more appealing for your child. You can also add medication to a very small spoonful of applesauce, ice cream, pudding or jelly to improve taste.
  • Pain medicine suppositories such as rectal Acetaminophen are available for children who often refuse to swallow medication. Acetaminophen suppositories are available without a prescription, but you might have to ask your pharmacists to get them as they are usually kept in a refrigerator at the pharmacy.
  • Chill the medicine, or have your child suck on a Popsicle or ice chips prior to taking the medicine (cold temperatures numb the taste buds). Then use the child's favorite cold drink as a chaser.
  • Try different medication dispensers for your child such as an oral syringe, dosage spoon, or small medicine cup.

When should I call the doctor?

Call your doctor if your child has any of the following:

  • Temperature higher than 102° F (38.9°C) that is not responsive to acetaminophen or ibuprofen.
  • Pain not relieved with ordered medication and tips listed here.
  • Nausea and/or vomiting after 24 hours.
  • Signs of dehydration: no urine for more than 8 hours, no tears, dry/sticky lips and tongue, or sunken eyes.
  • There is bleeding more than a streak in the saliva, especially if bright red and does not stop after 2-3 minutes.
  • Your child has a nose bleed.
  • Vomiting bright red blood.

Last Reviewed 7/2015 © Copyright

Medicine chart for                                                  (name)

  1. List each medicine, each time it is to be given, and the amount to give. List each medicine the same number of times as it is to be taken each day. (See example.) Add dates.
  2. Hang this chart where it can be easily seen, such as on a cupboard door or the refrigerator.
  3. Under each date, put a check mark after each medicine dose is taken.
  4. For as-needed medicines, write the time it was taken in the column for that date.

 

Times scheduled – Ex: 8 a.m. Medicines to give and amount – Ex: Medicine A, amount Date                        
                             
                             
                             
                             
                             
                             
                             
                             
                             

Questions?

This sheet is not specific to your child but provides general information. If you have specific questions about medicines, please ask the doctor, nurse, or pharmacist. For ideas on helping your child take medicine, call Children's child life department at Minneapolis campus: 612-813-6259, or St. Paul campus: 651-220-6465.

Helpful Links:

For tips on medication administration in toddlers and children including proper positioning and holding, watch the brief videos found in Children's education library:

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Family Resource Center library, or visit www.childrensmn.org/educationmaterials.

© 2017 Children's Hospitals and Clinics of Minnesota