European Journal of Pain (2002) 6: 213±219 doi:10.1053/eujp.2001.0326, available online at http://www.idealibrary.com on 1 Children's pain at home following (adeno)tonsillectomy Jan P. H. Hamers a and Huda Huijer Abu-Saad b a Section of Nursing Science, b Center for Nursing Research, Department of Health Care Studies, University of Maastricht, Maastricht, The Netherlands The aim of this study was to evaluate the prevalence and severity of children's pain at home following (adeno)tonsillectomies. The subjects were parents of 161 children (86 boys, 75 girls) undergoing myrin- gotomies, adenoidectomies and (adeno)tonsillectomies. The mean age of the children was 5.5 years (SD  2.4; range 1±14). Parents were asked to assess the child's average pain on the day of operation and 7 days after the operation, using a 100 mm Visual Analogue Scale (VAS). Parents from (adeno)tonsillectomy patients were also interviewed by phone on day 7. The mean VAS pain intensity scores by period (day of operation until 7th day after operation) differed between the myringotomy (3.2), adenoidectomy (10.6), and (adeno)tonsillectomy (22.1) group (F 2,133  31.65; p < 0.001). The VAS ratings were highest for the tonsillectomy group ( p < 0.001). There was a trend that pain intensity scores for adenoidectomies were significantly higher than scores for myringotomies ( p  0.07). In the interviews, 81% of the parents stated that their child suffered pain at home. However, this was not necessarily a reason to administer an analgesic. Furthermore, parents reported pain-related problems like problems regarding eating, fluid intake, vomiting and sleep disturbance. Finally, 67% of the children at home recalled severe pain experience in the hospital. It was concluded that especially following (adeno)tonsillectomies children suffer clinically significant pain at home and that the management of pain and related problems needs to be clearly improved. # 2002 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Science Ltd. All rights reserved. KEYWORDS: pain, (adeno)tonsillectomy, home, children. INTRODUCTION In many countries like the USA, UK, Canada, Finland, Germany and the Netherlands, minor surgeries are performed as an out-patient proce- dure (e.g. Astfalk et al., 1991; Gedaly-Duff and Ziebarth 1994; Tan et al., 1994; Finley et al., 1996; Kokki and Ahonen, 1997; Hamers et al., 1999). This is especially true for ENT-related operations, like tonsillectomy, adenoidectomy, and myrin- gotomy and tube placement (Yaster et al., 1994). It is known that the cost-savings of out-patient procedures are substantial (Yaster et al., 1994). These procedures are also assumed to be bene- ficial for children; they are known to reduce the child's stress by minimizing the extent of time spent away from home and family (Tan et al., 1994). The question is, however, whether this holds true for management of postoperative pain at home. Children undergoing (adeno)tonsillectomies are known to experience high levels of pain on the day of operation (Dommerby and Rasmussen, 1984; Bone and Fell, 1988; Warnock and Lander, 1998). In a study by Hamers et al. (1999) 60% of the children reported suffering extreme pain 1±2 hours after operation. This finding sup- ports physicians' and nurses' judgments that tonsillectomies are one of the most painful types of surgery in children (Kokke et al., 1993). Since Paper received 13 July 2001 and accepted in revised form 14 November 2001. Correspondence to: Dr. J. P. H. Hamers, University of Maastricht, Department of Health Care Studies, Section of Nursing Science, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Tel: 31 433881549; Fax: 31 433884162; E-mail: jph.hamers@zw.unimaas.nl 1090-3801/02/030213 + 07 $35.00/0 & 2002 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Science Ltd. All rights reserved.