Douleur et troubles comportementaux après adénoïdectomie et pose d’aérateurs transtympaniques chez l’enfant

Objectives

The purpose of this study was to evaluate postoperative pain in the hospital and at home as well as behavioural changes at home following outpatient adenoidectomy (VG) and ear tube (ATT) surgery.

Study design

Prospective cohort study.

Patients and methods

Sixty-four children (mean age 4.3 ± 2.4 years): 28 VG, 16 (ATT), 20 dual surgeries (VG-ATT). Postoperative pain was evaluated (arrival in recovery room, departure from wake-up room, departure from hospital) using the Objective Pain Scale (OPS). Parents evaluated their child's pain at home over a period of seven days using a numeric pain scale. Behavioural changes were measured with the Post-Hospital Behaviour Questionnaire (PHBQ).

Results

At arrival in the recovery room, OPS = 3.5 0–6]. A statistically significant difference (p < 0.05) was shown between the VG group (OPS = 5 2.25–7.75]), and the ATT (OPS = 0 0–5.5]) and VG-ATT (OPS = 2 0–5.75]) groups. OPS was 1.0 0–2] when leaving the recovery room, and OPS was 0 0–1] when leaving the hospital. Numeric pain scale scores recorded at home were extremely low. Postoperatively, 75% of parents at Day 1 and 40.6% at Day 7 reported at least one postoperative behavioural change.

Discussion

In all three groups, parents reported frequent postoperative behaviour changes despite adequate analgesia.

Conclusion

The relatively high frequency of postoperative behaviour changes in this population demonstrates the need to systematically evaluate those changes in order to improve overall paediatric care.