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Adenoid Surgery: Caring For Your Child After the Operation

Adenoids
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The adenoids are located behind the nose.
Your child needs an operation called an adenoidectomy to take out her adenoids. Adenoids are lumps of tissue, up behind the nose. You cannot see your child's adenoids when looking in the mouth. When adenoids are too large, they may need to be taken out.

Removing enlarged adenoids

Your child may have had enlarged adenoids since birth, or they may have grown too large from repeated infections. Enlarged adenoids can interfere with your child's breathing, especially at night when she is sleeping. Taking out adenoids improves breathing.

Enlarged adenoids can also affect the tubes that connect the middle ears and the back of the nose. If your child often has ear infections, an adenoidectomy may help her have fewer ear infections.

An otolaryngologist/head and neck surgeon will do the surgery. An otolaryngologist (say: OH-toe-lar-ing-GOLL-oh-jist) is a doctor who specializes in problems with the ears, nose, and throat.

Before the operation

Several hours before the operation, your child will need to stop eating and drinking. The doctor or nurse will tell you when your child must stop eating and drinking.

Write this information down here:

The date and time of the operation:

When your child must stop eating:

When your child must stop drinking clear fluids:

Other things to remember:

 

Surgery to remove the adenoids

The doctor will give your child a special "sleep medicine" called a general anesthetic. This will make sure your child sleeps through the operation and does not feel any pain.

While your child is asleep, the doctor will take out the adenoids through your child's mouth. The doctor will then stop the bleeding. Your child will not get stitches.

The operation will take between 20 and 45 minutes.

You will be able to see your child as soon as she is fully awake

A volunteer from the Surgical Waiting Room will bring you to see your child.

After the operation

After the operation, we will take your child to the recovery room, also called the Post Anesthetic Care Unit (PACU). This is where your child will wake up. Your child will stay in PACU for about 1 hour. We will then move your child to a room on the nursing unit.

Your child will be closely monitored on the nursing unit

  • Your child will be encouraged to take fluids by mouth. Your child will start with sips of clear fluids (liquids you can see through), ice chips, or freezies. Once your child can take sips, she can then drink liquids from a cup.
  • Your child’s temperature will be taken often.
  • Your child will still have an IV in her arm. When it is no longer needed for fluids or medicine, it will be taken out.
  • Your child will be given pain medicine if needed.
  • The nursing staff will watch your child for vomiting (throwing up) or bleeding.
  • The nurses will tell the doctor if there are any complications.
  • When your child is fully awake, she can get up with help to use the washroom.
  • Your child may throw up thick, brownish-coloured liquid if she swallowed some blood during or after the operation. This is normal. If your child keeps throwing up, we will give her medicine through the IV to help settle her upset stomach.

Managing your child's pain after the operation

If your child has pain after the operation, she will be given pain medicine either through the intravenous (IV) tube in the arm or by a liquid to swallow. Your child should have very little pain after the operation.

Your child will probably be able to go home on the same day

Most children are ready to go home from the hospital after about 3 hours in the nursing unit. Sometimes, children need to stay for a longer time.

You should take your child home in a car or a taxi. For your child's comfort and safety, do not take your child home by bus or subway.

Caring for your child at home

Pain

Follow these instructions when your child goes home after the procedure.

You may give your child medicine for pain.

You may receive a prescription for pain medication before you leave the hospital. Follow the dosage instructions give to you by the pharmacist. Although these prescription pain medications can be beneficial, they are also potentially very dangerous if not used properly.

When using these medications, if you notice any changes in either breathing or level of drowsiness that concern you, stop the medication and seek medical attention. If your child is unresponsive, call 911 immediately.

Do not give your child over-the-counter medicine that may have a sedative effect (makes people sleepy) while giving the prescription for pain medicine. Examples of these medicines are decongestants and antihistamines. Discuss these medications with your pharmacist.

You may give your child acetaminophen (such as Tylenol or Tempra) if he has pain. Give the dose printed on the bottle for your child's age. Do not give your child ibuprofen (Motrin, Advil, or Midol) or ASA (Aspirin) for 2 weeks after the surgery. These medications could increase your child's risk of bleeding after the operation. Check with the nurse or doctor first before giving these medicines to your child.

Diet

It is very important that your child have lots to drink after the operation. Let your child drink as much liquid as she wants. When your child can drink liquids without throwing up, she can eat soft foods. Then she can go back to eating what she normally eats.

Mouth care

Your child can rinse her mouth with water or brush her teeth gently. Do not let your child gargle.

Teach your child to sneeze with her mouth open. Do not let your child blow her nose for at least 1 week after the operation. She should dab her nose with a tissue if it is dripping.

To help your child breathe more comfortably, you can use a machine called a humidifier. This machine makes the air moist with a cool mist. Put it at your child's bedside.

Your child's voice may sound as if she is talking through her nose. This is normal. It may last for a few weeks or up to 3 months, if the adenoids were very large.

Activity

Your child should be as quiet as possible for about 2 or 3 days after the operation. Ask your doctor when it will be OK for your child to play contact sports again.

Your child may shower or bath as usual. Your child should stay away from crowds and people with infections and colds. Your child may return to school or daycare 5 days after the operation. You should not let your child go on long trips out of town for 2 weeks.

Your child may need a follow-up appointment

The clinic nurse will call you within 2 weeks of the operation to find out if your child has any problems and needs to see the doctor again. If your otolaryngology doctor has requested to see your child again in the clinic, we will make you an appointment for your child.

When to see a doctor

Please call your child's otolaryngologist, the otolaryngology clinic nurse, or your family doctor if your child has any of the following signs after going home:

  • fever of 38.5°C (101°F) or higher

  • vomiting (throwing up) that does not stop

  • pain that gets worse

  • refusing to drink

  • child does not urinate (pee) within 12 hours of the operation

  • fresh blood in the nose or mouth

If your child is bleeding or having trouble breathing, or if you are worried, do not wait. Take your child to the closest emergency department.

Write down contact information here:

Otolaryngologist's name and number:

Otolaryngology clinic number:

Family doctor’s name and number:

 

Key points

  • Your child’s enlarged adenoids will be removed in a surgical procedure.

  • You child will be asleep and feel no pain when the adenoids are removed.

  • Most children can go home the same day as the operation.

  • It will take a few days before your child can return to her regular activities and food.  

Kathy Eres, RN
Tomka George, RN
Pauline Lackey, RN
Paolo Campisi, MSc, MD, FRCSC, FAAP

5/30/2008
 




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