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What should be expected following a tonsillectomy?

1) After the procedure, the patient may experience moderate to severe throat and/or ear pain. (The ear pain may start five to seven days after the surgery.)

To help alleviate this pain:

Regular doses of the pain medication prescribed by your doctor should be given every four hours while the patient is awake. This should be continued for the first five to seven days. Your child may need prescription pain medicine for seven to ten days. This is completely normal. Please do not use Aspirin after tonsillectomy for at least two weeks unless specifically instructed by your surgeon.  Your child may take Ibuprofen (Advil/Motrin) after the first day post op occasionally to help with pain relief.

The use of cool compresses and ice collars on the neck, ice chips or constant sipping of fluids may also help decrease throat pain.

Encourage fluid intake at least every waking hour for at least 7-10 days after surgery (Soft drinks, fruit juice, Jell-O, Popsicles, Gatorade, Pedialyte, etc.).

Hard candy, lollipops and gum can be used to encourage swallowing.

2) Your child may lack energy and/or act listless for several days following the surgery. The third day may be the worst.

Your child should rest at home for the first two days. Strenuous activity, rigorous play or contact sports should be avoided for two weeks. If the patient attends school, he/she can return to school seven days after surgery, but should not participate in gym class or recess for two weeks.

3) Bad breath may last for ten to fourteen days following the procedure.

4) Some nausea and vomiting may occur following surgery.
Phenergan suppositories are routinely prescribed to help treat nausea.  Please use as prescribed.

5) Constipation may be noted for several days following the procedure. The narcotic (pain) medicine your child is taking will make this worse. Feel free to give daily doses of milk of magnesia to keep regular bowel movements.

6) We strongly recommend that your child stay in the local area for a
minimum of two weeks after surgery due to the small but important risk of
bleeding.

What are some reasons you should contact your doctor after surgery?

1) Fever between 99 – 101(F) degrees may be noted for the first three to four
days following the procedure. However, if your child has a fever over 102° (F) you should first consider how much fluid is being taken. If fluid intake is small, increase fluids and continue pain medicine. If the fever persists, please contact your doctor.

2) Nausea and vomiting may be noted after the procedure, but if the nausea or
vomiting becomes persistent, interfering with fluid intake, or blood is noted in the emesis (vomit), your doctor should be contacted.

3) Your doctor should be contacted if fluid or food intake is too low. Recommended fluid intake for the first 24 hours should be at least:

Weight of patient cc’s glasses (8oz)
Over 20 pounds 1000 4
Over 30 pounds 1250 5
Over 40 pounds 1500 6
Over 50 pounds 1750 7
Over 60 pounds 2000 8. 5

4) Any bright red bleeding seen from the mouth or nose should be reported to
your doctor immediately. If bleeding is noted, rinsing or gargling with ice water will help slow or stop it while you are calling the doctor.

No hard crunchy, foods ( tacos, pizza crusts, pretzels, chips, etc.) should be eaten for two weeks after the procedure to help avoid irritating the area.

Please refer to this when the nurses call you post-operatively.

Thomas M. Andrews

M.D.

Dr. Andrews specializes in the medical and surgical treatment of ear, nose and throat disorders of children and adolescents. His accreditations include Florida State Medical License and Ohio State Medical License. He is also a board member of the National Board of Medical Examiners and American Board of Otolaryngology, Head and Neck Surgery