Barns smärta efter tonsillektomi-en litteraturstudie

Sammanfattning: Background: Tonsillectomy is the most common surgery on children in Sweden. Research shows that children are suffering of postoperative complications such as pain and dehydration after this surgery.  Aim: The aim of this literature review is to examine how children experience postoperative pain after tonsillectomy, what affects the pain experience and how the pain can be relieved at home. A second aim is to examine if children get adequate pain relief after tonsillectomy. Method: A literature review based on 12 original articles. Result: The majority of the children experienced moderate to severe pain the first two days after tonsillectomy, the pain was worse than they expected and could last for up to 14 days. The children felt, among other things, afraid, worried and tired. Older children as well as children who were temperamental, easily distracted, depressed or anxious reported higher pain intensity. The children’s sleep, as well as food and fluid intake was affected negatively by the pain. Preoperative education in pain and pain management after tonsillectomy positively affected the pain experience of the children. The children used their own methods, such as distraction, sleep and cold to relieve the pain. Even specially developed methods such as "imagery" and speech therapy relieved children's pain. Children generally received too little analgetics at the hospital and at home even though they had significant pain after tonsillectomy. Conclusion: The study shows that children experience postoperative pain after tonsillectomy very different and that the pain is under treated. This imposes a requirement of personalised nursing, the nurse needs sufficient knowledge of children's experiences, pain relief methods and measures to relieve pain after tonsillectomy. The authors finally want to emphasise that in order to get better knowledge about the duration of the pain and pain patterns after a minor surgery, such as tonsillectomy, studies longer than two to three days are needed. Keywords: postoperative pain, child, tonsillectomy, experience, management