Table 4. Caregiver Counseling Summary for Tonsillectomy
and SDB
Hypertrophic tonsils may contribute to SDB in children.
SDB oen is multifactorial.
Obesity plays a key role in SDB in some children.
Polysomnography is considered the best test for diagnosing and measuring outcomes in
children, but it is not necessary in all cases, and access may be limited by availability of sleep
laboratories and willingness of insurers and third-party payers to cover the cost of testing.
Tonsillectomy is effective for control of SDB in 60%-70% of children with significant
tonsillar hypertrophy.
Tonsillectomy produces resolution of SDB in only 10%-25% of obese children.
Caregivers need to be counseled that tonsillectomy is not curative in all cases of SDB in
children, especially in children with obesity.
Table 5. Posttonsillectomy Pain Management Education
for Caregivers
roat pain is greatest the first few days aer surgery and may last up to 2 wks.
Encourage your child to communicate with you if he or she experiences significant throat
pain, because pain may not always be expressed and therefore not recognized promptly.
Discuss strategies for pain control with your health care provider before and aer surgery.
Realize that antibiotics aer surgery do not reduce pain and should not be given routinely
for this purpose.
Make sure your child drinks plenty of liquids aer surgery. Staying well hydrated is
associated with less pain.
Ibuprofen can be used safely for pain control aer surgery.
Pain medicine should be given as directed by your health care provider. Especially for the
first few days aer surgery, it should be given oen.
Many clinicians recommend not waiting until your child complains of pain. Instead, the
pain medication should be given on a regular schedule.
Expect your child to complain more about pain in the mornings – this is normal.
Pain medication may be given rectally if your child refuses to take it orally. Call your health
care provider if you are unable to adequately control your child's pain.
