On average, 3.9 million pediatric surgeries are performed each year in the U.S. ranging from appendectomies and hernia repairs to spinal fusions and tonsillectomies. The current standard of care for managing pain following these types of surgeries is opioids, which often come with unwanted side effects including nausea, vomiting, constipation, etc. If your child is preparing to have surgery, ask about non-opioid options that can manage their pain and provide an enhanced recovery experience. There are now long-acting, non-opioid medications to treat pain in patients as young as 6 years old that can help reduce or, in some cases, eliminate the need for these powerful medications among this vulnerable population.
See below for more details on each of these procedures and what to expect following surgery.
Appendectomy (Appendix Removal)
What is an Appendectomy?
An appendectomy, the removal of the appendix, is often performed as an emergency procedure to treat acute appendicitis, which is the inflammation or infection of the appendix. Appendicitis causes severe pain in the lower righthand side of the stomach and is very common in children, teens, and young adults.
According to a report from the Agency for Healthcare Research and Quality, appendectomies were the most common surgery performed during hospital inpatient stays on children 17 years old and younger in 2012.
What can I expect?
After the surgery, your child will be encouraged to get up and move around later that day or the next day. Children often go home a day or two after the surgery. Those at higher risk for infection may need to stay longer to receive IV antibiotics. This is typical for children whose appendix ruptured (burst) before the surgery.
Follow all instructions for cleaning and dressing the wound, keeping it dry, and showering. It’s important to avoid baths, pools, or soaking the wound until the doctor provides clearance. Most children can resume many of their usual activities about a week after surgery. Talk to your healthcare provider about dietary restrictions the first few days home and how long your child should wait before returning to more physical activity such as bike riding, running, contact sports, or gym class.
Spinal fusion procedures are commonly performed on children and teens to help with scoliosis or other spine problems. It is called “fusion” because the surgery lets two or more bones in the spine (vertebrae) fuse (grow together) into one solid bone. This helps the spine grow in a straighter position and sometimes eases back pain.
What can I expect?
Patients who have a spinal fusion may stay in the hospital for 2-3 days; however, children who have severe scoliosis or other medical conditions might need a longer hospital stay. This gives them time to recover from surgery and increase their movement. By the time they go home, they should be able to walk around and do many day-to-day things, such as shower, dress themselves, and climb stairs.
Most children are cleared by their doctors to go back to school 3-4 weeks after the surgery with some limitations. Because it takes time for the bones to fuse, it is recommended that children wait at least 2-6 months to return to gym class or recreational sports. Sometimes children need physical therapy to complete their recovery, which may start 4–6 weeks after surgery and can continue for several months.
What is a Hernia?
A hernia forms when an organ or group of tissues push through a weakened part of a muscle wall. Hernia repair is one of the most common pediatric operations performed. There are several types of hernia including inguinal (groin), ventral (abdomen), and umbilical or epigastric (often noticed shortly after birth around the belly button or upper abdomen).
What can I expect?
In most cases, hernia repair can be performed as an outpatient procedure, meaning your child will likely go home the same day. Talk to the doctor about precautions to take at home, like avoiding lifting heavy backpacks, and icing the area of your child’s hernia repair to help reduce swelling. It is recommended that children avoid major physical activity for 1 week after surgery, and it can take up to 2 weeks for the incision from a hernia to completely heal.
Tonsillectomy (Tonsil Removal)
What is a Tonsillectomy?
A tonsillectomy is the surgical removal of the tonsils, two small glands located in the back of your throat – one tonsil on each side. A tonsillectomy is often performed to treat recurring tonsillitis – an infection of the tonsils that causes them to swell. Although tonsillitis is usually caused by a virus, the bacteria that causes strep throat is also a common trigger. Other symptoms of tonsillitis include fever, trouble swallowing, and swollen glands around your neck. Tonsillitis and tonsillectomies are more common in children than adults; however, people of any age can experience trouble with their tonsils and require surgery.
Tonsillectomy is one of the most common surgical procedures in the U.S, with 500,000+ cases performed annually in children 17 years old and younger.
What can I expect?
In most cases, tonsillectomies are performed as an outpatient procedure, meaning your child can go home the same day as their surgery. Patients will experience some pain and may have a sore throat after surgery. Be cautious about the types of foods and drinks you give your child after a tonsillectomy. Ice water and ice pops can help keep them hydrated and help to address pain and swelling. Other ideal food choices for the first few days following surgery include warm, clear broth, applesauce, or yogurt, since hard, crunchy snacks such as cereals and pretzels can lead to bleeding. It is often recommended that children stay home from school for 1-2 weeks following surgery.