Perioperative nursing based on the rapid rehabilitation concept reduces pain, accelerates recovery, and improves quality of life in children undergoing adenoidectomy.

BACKGROUND

The rapid rehabilitation concept is widely adopted in adult surgery but remains underexplored in pediatric otolaryngology. This study evaluated enhanced perioperative nursing based on this concept in children undergoing endoscopic adenoidectomy.

METHODS

In this prospective quasi-experimental study, 102 children (aged 1 to 12 years) undergoing endoscopic adenoidectomy were allocated to an observation group (OG, n = 51) receiving enhanced perioperative nursing (preoperative psychological preparation and carbohydrate loading, intraoperative normothermia, postoperative multimodal analgesia, early nutrition, and graded mobilization) or a control group (CG, n = 51) receiving routine care. The primary outcome was pain at postoperative day 3 (FLACC scale). Secondary outcomes included hospital stay, symptom resolution, quality of life (OSA-18), complications, and parental satisfaction.

RESULTS

The OG had significantly lower FLACC pain scores at day 3 (median 2.0 vs. 4.0; p < 0.001; r = 0.62) and shorter hospital stay (4.2 vs. 5.8 days; p < 0.001; d = 1.33). Resolution of nasal congestion, rhinorrhea, nasal flaring, and sleep snoring was significantly faster (all p < 0.001; d = 1.05 to 1.29). At 3 months, OSA-18 scores were lower across all five dimensions (all p < 0.001; d = 0.87 to 1.07). Complication rates were lower (2.0% vs. 13.7%; p = 0.028), with higher compliance (96.1% vs. 84.3%; p = 0.046) and parental satisfaction (98.0% vs. 82.4%; p = 0.007).

CONCLUSION

Perioperative nursing based on the rapid rehabilitation concept improved pain control, accelerated recovery, enhanced quality of life, and increased compliance and parental satisfaction in children undergoing adenoidectomy.