Unlike children under 12 years who undergo tonsil removal surgery, adults undergoing tonsillectomy is perhaps one of the most painful recoveries anyone will ever experience in their lifetime. The pain can be quite vicious and prolonged, typically lasting about 3 weeks. Adults on average lose about 5 pounds due to inability to eat solid foods and decreased caloric intake. In spite of a liquid diet and multiple prescriptions for pain control, it is still a miserable recovery. In our office, 3 pain control prescriptions are given: a neuromodulating drug (ie, neurontin), tramadol, and a narcotic.
Another way to minimize pain that is offered is to inject a long-lasting numbing medication (ie, 0.25% bupivacaine), but even this intervention has it's downside; although the pain is decreased by ~50%, when it wears off in about 2-3 days, the pain spikes causing some patients to be concerned that something terrible just happened. As such, at least in our office, patients are given the choice whether they desire this numbing injection or not prior to surgery. It works out to about 50% of patients refusing the numbing injection in order to avoid the surprise pain spike a few days later.
The graph above illustrates what the pain level is like for adults over time both with and without receiving the numbing injection.
It is unclear exactly why young children experience so much less pain than adults, but the typical rationale I provide is that children's pain nerve endings are not as fully developed as an adult's.
Check out the video below showing a time lapse of tonsillectomy healing from 0 to 25 days.
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