Post-Tonsillectomy Pain Control for Children

Tonsillectomy Рpain control without narcotic 

One of the most difficult aspects of recovering from a tonsillectomy is pain control. Here are some tips to help you:

In younger children narcotics are unsafe and they do not work any better than the combination of ibuprofen and acetaminophen. The pain medications we recommend are over-the-counter liquid acetaminophen (Tylenol) and ibuprofen (Advil). They are unique and can be given together.
Purchase liquid acetaminophen 160mg/5ml and ibuprofen 100mg/5ml

Pain is best controlled by staying ahead of it. Administering pain medications on a schedule for the first few days is recommended. Setting an alarm in the middle of the night is wise. The frequency of acetaminophen and ibuprofen is every four hours. During the day they can be alternated so that every two hours your child gets either acetaminophen or ibuprofen.

Dosing: It is important to be accurate with the dosing. A syringe should be used to measure the exact amount in ml. We recommend avoiding teaspoons because they are not accurate and they can be confused with tablespoons. If you are not sure about the dosing, talk to your pharmacist or call our nurses. The following doses can be given every 4 hours:

Weight: ____________

9-14 kg (20-32 lbs)
Ibuprofen 3 ml (assuming the strength is 100mg/5ml)
Acetaminophen 3.5 ml (assuming the strength is 160mg/5ml)

15-22 kg (33-49 lbs)
Ibuprofen 5 ml (assuming the strength is 100mg/5ml)
Acetaminophen 5.9 ml (assuming the strength is 160mg/5ml)

23-29 kg (50-65 lbs)
Ibuprofen 7.5 ml (assuming the strength is 100mg/5ml)
Acetaminophen 8.8 ml (assuming the strength is 160mg/5ml)

30-37 kg (66-82 lbs)
Ibuprofen 10 ml (assuming the strength is 100mg/5ml)
Acetaminophen 11.7 ml (assuming the strength is 160mg/5ml)

38-44 kg (83-98 lbs)
Ibuprofen 12.5 ml (assuming the strength is 100mg/5ml)
Acetaminophen 14.6 ml (assuming the strength is 160mg/5ml)

45kg and up (99 lbs and up)
Ibuprofen 15 ml (assuming the strength is 100mg/5ml)
Acetaminophen 17.6 ml (assuming the strength is 160mg/5ml)

Exact dosing
Ibuprofen weight (in kg) / 3 = _______ ml (assuming strength as above)

Acetaminophen weight (in kg) / 2.6 = ________ ml (assuming strength as above)

Hydration can reduce pain. It is very important to stay hydrated.

If your doctor has given you different or more specific instructions, those instructions should be followed. Do not hesitate to contact us if there is any confusion or problems. There is always a doctor on-call to help you.