Perioperative pain management in pediatric otolaryngology-head and neck surgery

Pain management for children after otolaryngologic procedures is challenging and even controversial. The importance of adequate pain control for children after surgery is well understood, but debates about analgesia protocols center on the risks of opioids for children with obstructive sleep apnea as well as potential bleeding risk with the use of nonsteroidal antiinflammatory drugs. In this chapter, we review perioperative pain management for the two most common procedures in pediatric otolaryngology: tympanostomy tube placement and tonsillectomy. We focus on special considerations in pediatric patients, pharmacologic and nonpharmacologic interventions, and the evidence supporting their efficacy and possible adverse effects.