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J Adv Nurs. 2013 Sep;69(9):2054-65. doi: 10.1111/jan.12072. Epub 2013 Jan 13.

A randomized clinical trial of a nurse telephone follow-up on paediatric tonsillectomy pain management and complications.

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1
CHU Sainte-Justine, Montreal, Quebec, Canada.

Abstract

AIMS:

To determine the effect of a nurse telephone follow-up on paediatric post-tonsillectomy pain intensity, complications, and use of other healthcare services.

BACKGROUND:

After tonsillectomy, children experience moderate-to-severe pain for days. Parents tend to give insufficient analgesia, with resulting increases in pain and postoperative complications. In adults, nurse telephone follow-up for ambulatory surgeries reduces postoperative pain.

DESIGN:

The study design was a randomized clinical trial.

METHODS:

In this trial, children aged 4-12 years undergoing elective tonsillectomy in June-October 2010 were assigned to a nurse telephone follow-up with parents on postoperative days 1, 3, 5 and 10, or standard care with no follow-up but data collection. Outcomes included pain intensity, analgesics administered, complications, and healthcare use.

RESULTS:

Of 45 participants, the intervention group (n = 24) received more analgesics on postoperative days 1 and 3, increased their fluid intake at days 1 and 3, but had more constipation at day 3 than the control group (n = 21). There was no significant difference regarding pain intensity or use of healthcare resources.

CONCLUSION:

Nurse telephone follow-up was beneficial for some pain management and prevention of complications, although better analgesic treatments are needed. The intervention was simple, safe, and appreciated by parents.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01568372.

KEYWORDS:

aftercare; children; day surgery; nurses/midwives/nursing; nursing interventions; paediatric pain management; parent; postoperative complications; postoperative pain; tonsillectomy

PMID:
23311981
DOI:
10.1111/jan.12072
[Indexed for MEDLINE]

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