Tonsillectomy – With or Without Adenoidectomy

  1. We recommend that you:
    • Rest quietly for the first several days after surgery. Then, avoid strenuous exertion for 3 weeks. 
    • Do not go out of town for two weeks after surgery in case there is bleeding or some other unexpected issue. 
    • Drink cool water and allow ice chips to melt in your mouth immediately after and as much as possible on the day of surgery. A soft diet with plenty of cool liquids is best during the first week after surgery. Solid foods are OK but the patient should chew them thoroughly before swallowing. Citrus fruits, spicy, hot, or crunchy foods may irritate your throat.
  2. What to expect after your tonsillectomy:
    • Nausea is common for 24-48 hours after surgery. If vomiting persists for more than 48 hours or vomiting is frequent, call our office at 704.752.7575, extension 113.
    • Fever above 100 degrees F is normal for 48-72 hours after general anesthesia and does not indicate infection. 
    • Pain radiating from the throat to the ears is common after tonsillectomy. Treat it like throat pain.
    • Increased pain around the 7th-10th day following surgery may occur as a result of normal healing.
    • After surgery, it is normal for the throat to appear white with a cheesy coating, and for the patient to have bad breath. This is temporary and a normal part of the healing process.
  3. In case of bleeding:
    • If bleeding is going to occur, it will typically happen 6-14 days after surgery. In the case of bleeding, we recommend that the patient suck on ice chips, spit out all the blood, and stay quiet until it stops. If bleeding continues for more than 30 minutes, call our office at (704) 289-8220 extension 113. After hours, listen carefully to the prompts. There is an ENT physician on call every night and weekend, 24/7. If for any reason you cannot speak to one of our physicians and bleeding persists, go directly to the Emergency Room at Atrium Health Union if possible, but continue to try to contact the ENT physician. The ER physician will evaluate you and then speak to the ENT doctor on call.
  4. Avoid dehydration:
    • Drink ample fluids regularly. Staying hydrated will help lessen the pain. If the patient is not drinking regularly due to pain, or not able to tolerate the pain medication, please call our office to discuss alternative plans.

Post-Tonsillectomy Pain Control

For Treatment of Discomfort in Pediatric Patients:

  • Acetaminophen (Tylenol) every 6 hours at weight appropriate dosage. AND
  • Ibuprofen (generic Motrin or Advil) at weight appropriate dosage every 6 hours, beginning the day after surgery. 
  • We recommend for the first week that you wake the patient to give them their medicine 6 hours after their last PM dose.

For Patients Over 6 Years Old:

  • Use the above protocol for mild discomfort. Adults under 160 pounds may use 3 over-the-counter (200 mg) Ibuprofen tablets. Those over 160 pounds may use 4 over-the-counter Ibuprofen tablets. All adults should also use two regular strength (325 mg) Tylenol tablets at the same time.
  • A prescription pain medication containing a narcotic and Tylenol (APAP on the bottle) may also be given. For moderate or severe pain, 1-2 prescription pain pills may be used to replace one or two Tylenol in the above protocol. DO NOT give 2 prescription pain pills and 2 Tylenol at the same time or it could lead to potentially permanent liver failure. It is acceptable to give 1 pain pill and 1 Tylenol along with the recommended dose of Ibuprofen together for moderate pain.
  • For adults the options for a 200 pound person would be 2 Tylenol and 4 Ibuprofen (mild), 1 Tylenol with 1 prescription pain pill and 4 Ibuprofen (moderate), or 2 prescription pain pills and 4 Ibuprofen for the most severe pain.