Effect of Cold Diet and Diet at Room Temperature on Post-Tonsillectomy Pain in Children

Document Type: Original

Authors

1 Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

2 Department of Anesthesiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Abstract

Introduction:
The present study aimed to compare the effect of cold diet and diet at room temperature on post-tonsillectomy pain in children.
 
Materials and Methods:
In the present study a total of 120 children within the age range of 4-12 years who underwent tonsillectomy were randomly assigned to two groups, namely group C with a cold-served diet and group room temperaturewith a room-temperature-served diet postoperatively. Each patient’s post-operative pain was evaluated using the Face, Legs, Activity, Cry, Consolability (FLACC) scale prior to oral diet initiation after the operation, before thesecond acetaminophen dose, before the next day breakfast, and before discharge.
 
Results:
Out of 103 children, 48 and 55 children were femaleand male, respectively. The average age of the children was 7 years and 2 months. There was no significant difference in gender and age between the two groups. There were no significant differences in the mean scores of FLACC scale between the two groups at different times, including before starting an oral diet (P>0.15), before the second dose of acetaminophen (P>0.22), before the next day breakfast (P>0.32), and before discharge (P>0.83). In terms of bleedingfrequency, as well as nausea and vomiting, no significant difference was observed between the two groups.
 
Conclusion:
The obtained results of this study indicated that using cold liquids and foods after tonsillectomy did not have a significant effect on post-tonsillectomy pain in children. According to the findings, it is not rational to advise the mother or the child about the temperature of fluids and foods consumed post-tonsillectomy.

Keywords

Main Subjects


1. Júnior JFN HD, Américo RR, Stamm RG, Hirata CW. A Brief History of Tonsillectomy. Int Arch Otorhinolaryngol 2006;10(4):314-7.

2. Baugh RF, Archer SM, Mitchell RB, Rosenfeld RM, Amin R, Burns JJ, et al. Clinical practice guideline: tonsillectomy in children. Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery. 2011;144(1 Suppl):S1-30.

3. Flint PW. Cummings otolaryngology: head & neck surgery. 6th ed. Philadelphia, PA: Elsevier/Saunders; 2015.

4. Idvall E, Holm C, Runeson I. Pain experiences and non-pharmacological strategies for pain management after tonsillectomy: a qualitative interview study of children and parents.J Child Health Care.2005;9(3):196-207.

5. Sutters KA, Savedra MC, Miaskowski C, Holdridge-Zeuner D, Waite S, Paul SM, et al. Children's expectations of pain, perceptions of analgesic efficacy, and experiences with nonpharmacologic pain management strategies at home following tonsillectomy. J Spec Pediatr Nurs. 2007;12(3):139-48.

6. Bulteau V. Letter: Tonsillectomy: ice cream myth. Med J Aust. 1976;1(1-2):34.

7. Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23(3):293-7.

8. Nilsson S, Finnstrom B, Kokinsky E. The FLACC behavioral scale for procedural pain assessment in children aged 5-16 years. Paediatr Anaesth. 2008;18(8):767-74.

9. Redmann AJ, Wang Y, Furstein J, Myer CM, 3rd, de Alarcon A. The use of the FLACC pain scale in pediatric patients undergoing adenotonsillectomy. Int J Pediatr Otorhinolaryngol. 2017;92:115-8.

10.Vons KM, Bijker JB, Verwijs EW, Majoor MH, de Graaff JC. Postoperative pain during the first week after adenoidectomy and guillotine adenotonsillectomy in children. Paediatr Anaesth. 2014;24(5):476-82.

11. Novoa E, Schlegel-Wagner C. Hot water irrigation as treatment for intractable posterior epistaxis in an out-patient setting. J Laryngol Otol. 2012;126(1):58-60.

12. Schlegel-Wagner C, Siekmann U, Linder T. Non-invasive treatment of intractable posterior epistaxis with hot-water irrigation. Rhinology. 2006;44(1):90-3.

13. Haraji A, Rakhshan V, Hosseini V. Local heating of the wound with dressings soaked in saline at 42 degrees C can reduce postoperative bleeding: a single-blind, split-mouth, randomised controlled clinical trial. Br J Oral Maxillofac Surg. 2016;54(3):266-9.

14. MacGregor FB, Albert DM, Bhattacharyya AK. Post-operative morbidity following paediatric tonsillectomy; a comparison of bipolar diathermy dissection and blunt dissection. Int J Pediatr Otorhinolaryngol. 1995; 31(1):1-6.

15. Temple RH, Timms MS. Paediatric coblation tonsillectomy. Int J Pediatr Otorhinolaryngol. 2001;61(3):195-8.

16. Sylvester DC, Rafferty A, Bew S, Knight LC. The use of ice-lollies for pain relief post-paediatric tonsillectomy. A single-blinded, randomised, controlled trial. Clin Otolaryngol. 2011;36(6):566-70.

17. Rotenberg BW, Wickens B, Parnes J. Intraoperative ice pack application for uvulopalatoplasty pain reduction: a randomized controlled trial. Laryngoscope. 2013; 123(2): 533-6.

18. Shin JM, Byun JY, Baek BJ, Lee JY. Effect of cold-water cooling of tonsillar fossa and pharyngeal mucosa on post-tonsillectomy pain. Am J Otolaryngol. 2014;35(3):353-6.

19. Robinson SR, Purdie GL. Reducing post-tonsillectomy pain with cryoanalgesia: a randomized controlled trial. Laryngoscope. 2000; 110(7):1128-31.

20. Forsgren H, Heimdahl A, Johansson B, Krekmanov L. Effect of application of cold dressings on the postoperative course in oral surgery. Int J Oral Surg. 1985;14(3):223-8.