A tonsillectomy is the surgical extraction of the tonsils, which are two pads of glandular tissue on both sides of the back of the throat. Tonsils help protect the body against infection which may enter by the nose or mouth. They are prone to infection and enlargement, which can lead to a condition called tonsillitis. A doctor usually suggests a tonsillectomy when the condition is frequent and critical or causes complications.
A tonsillectomy is performed under general anesthesia. The surgeon will use a specific device to keep the mouth open so that they can see the tonsils during the procedure. The procedure takes almost 45 to 60 minutes. This includes the anesthetic, the operation and time spent in the recovery room.. This includes the anesthetic, the operation and time spent in the recovery room.
Your kid will stay in hospital overnight for observation. Since the new and advanced procedures are minimally invasive which does not include cuts and wounds, and are painless, the patient is allowed to go home the next morning.
Preparation before surgical procedure
Well, in most cases, a patient has to stop taking blood-thinning medications. Also, your child’s specialist may ask you to stop medications such as aspirin and ibuprofen for 72 hours before the operation.
All kids react differently to surgery. Some cry, get distressed or open their eyes wide to stay alert, or very sleepy. But what a parent needs to do is convince the child that a doctor is to designated to help. A child may feel better and get treatment and medications.
For the first couple of hours, your child will be allowed to consume fluids such as water, cordial, ice block, etc. Once the kid starts to tolerate clear fluids, the kid may then be allowed to have non- carbonated fluids such as milk, ice-cream, and custard.
Many kids refuse to drink fluids because of throat pain, but they must be asked to drink a lot of fluids to avoid dehydration. This can lead to increased pain and a high chance of bleeding. Afterward, returning to the recovery room or observation room, a kid can eat regular meals. In the first eight hours, a kid may eat without too much discomfort after a local anesthetic used in the surgery.
It is of utmost importance to maintain the child’s fluid intake to prevent dehydration at home. A kid should be allowed to continue the normal diet as well as routine. Some foods may cause discomfort when eating so it should be avoided for a few weeks. Chewing gum or lollies will increase saliva production and help to reduce jaw stiffness.
Mouth care and physical activities
During the healing process, a patient may get bad breath. Drinking plenty of water will help reduce the odor and teeth should be brushed as normal. The area from where the tonsils have been removed may turn yellow/white which is also normal.
Your kid may need to stay home, i.e. not go to school or childcare for a week and should avoid all sports and rough play. Also, ask your kid to take rest, play games such as puzzles, reading and watching DVDs at home.
After the treatment, a pain relief medication will be prescribed by the doctor. Paracetamol and Oxycodone are used for pain relief after tonsillectomy. Throat pain persist for a few days and is at its worst around the fifth or sixth day after surgery. Pain will then ease until the seventh or ninth day after surgery when some of the scab covering the tonsillectomy site falls off.
Moreover, after a week, the pain with subside. There have been cases where kids have experienced a mild earache after a tonsillectomy. Mostly because the ears and the tonsils share the same nerve. It is crucial to give a kid with regular pain relief during the recovery process. This may include waking them at night for one or two days after the surgery.
Do’s and Don’ts
- Do not wait for your kid to say they have pain; see that they take their medication and eat or drink properly else it may be putting them at risk of bleeding and dehydration
- Paracetamol (PCM) can be given every four to six hours as directed with a maximum of four doses per 24 hours
- If pain is not relieved by Paracetamol alone, Oxycodone can also be used; it can be given every four to six hours, with a maximum of four doses per 24 hours
- It is important for you and other carers to record the name of the medication, and the date and time you have given it to keep track of medication usage
- Do not give your child Aspirin, as mentioned above, for two weeks after the operation. Ibuprofen may be given after the operation, but at the doctors’ discretion
- Do not give any pain relief medicines without checking with a doctor as some salts may double-up with prescribed medication
- Local anesthetic lozenges can also be used by older children to supplement pain relief
Do you need to seek urgent medical attention after your kid’s Tonsillectomy?
Call your doctor or the hospital immediately if your child:
- has red blood in their nose or mouth
- has high temperatures above 380C
- has increased throat pain which is not relieved by medication
- is not eating or drinking
- is nauseous or vomiting with no sign of relief
- is dehydrated
- increasingly unwell
A review or a follow up will be advised by the doctor for your child after the surgical procedure. The same will be performed at an outpatient basis. If you have any concerns before the review, schedule a follow-up with the surgeon. An ENT specialist is the best person to share the exact answer to you.