Tonsillectomy and Adenoidectomy Surgical Instructions

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What happens after surgery?

After surgery, the patient will be taken to the recovery room where a nurse will monitor them. Relatives are generally invited into the recovery room as the patient becomes aware of their surroundings, and if the patient is a child, they will be looking for his or her parent(s) or caregiver. The patient, will be able to go home the same day as the surgery once they have fully recovered from the anesthetic. This usually takes several hours. The patient will need a friend or family member to pick them up from the surgical facility to take them home. A relative, caregiver, or friend should spend the first night after surgery with the patient.

When the patient arrives home from the surgical facility, they should go to bed and rest with the head elevated on 2-3 pillows. Keeping the head elevated above the heart minimizes edema and swelling. Applying an ice pack to the neck may help decrease swelling. The patient may get out of bed with assistance to use the bathroom. Visitors should be kept to a minimum since they may unknowingly expose the patient to infection, or cause over excitement. If the patient is constipated, avoid straining and take a stool softener or a gentle laxative.

Once the patient has recovered from the anesthetic, if tolerable, a light, soft, and cool diet is recommended. Avoid hot liquids for several days. Even though the patient may be hungry immediately after surgery, it is best to feed slowly to prevent postoperative nausea and vomiting. Occasionally, the patient may vomit one or two times immediately after surgery. However, if it persists, the doctor may prescribe medications to settle the stomach. It is important to remember that a good overall diet with ample rest promotes healing. Weight loss is very common following a tonsillectomy. The patient need not worry about nutritional requirements during the recovery so long as they are drinking adequate amounts of fluid.

The patient may be prescribed antibiotics after surgery. The patient should take all of the antibiotics prescribed by the doctor. Some form of a narcotic will also be prescribed (usually acetaminophen/Tylenol with codeine), and is to be taken as needed. If the patient requires narcotics he or she is cautioned not to drive. If the patient has nausea or vomiting postoperatively, the patient may be prescribed anti-emesis medications such as promethazine (Phenergan) or ondansetron (Zofran). If the patient or caregivers have any questions or feel the patient is developing a reaction to any of these medications, a doctor should be consulted. Patients should not take or give any other medications, either prescribed or over-the-counter, unless they have been discussed with the doctor. Continue Reading

Reviewed on 11/3/2015
References
Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

REFERENCE:

Tonsillectomy and adenoidectomy in children: Indications and contraindications
UpToDate.com

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