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Master Thesis

Intérêt de l’utilisation d’une application pour smartphone dans l’optimisation du contrôle de la douleur après amygdalectomie chez l’enfant

Abstract : Background : Literature suggest that pain control is insufficient in children after tonsillectomy. To use a smartphone application looks promising to improve postoperative pain management. To our knowledge, there is no pediatric study. Our aim is to evaluate a smartphone application with messages delivery guiding the use of analgesic drugs to improve postoperative pain management following tonsillectomy in children.
Methods: In this preliminary randomized clinical trial, we included and randomized all patients who underwent tonsillectomy into two groups: a standard follow-up group (STAND) versus a personalized follow-up (PERSO). Following hospital discharge, parents were asked to record post-operative pain and side effects by using a smartphone application. Patients in the PERSO group received additional notifications to improve drug administration. The primary outcome was postoperative pain level assessed by the PPMP-SF scale. Data about analgesic treatment, perioperative side effects and parental satisfaction were also analyzed.
Results: From October 2018 to May 2019, 114 patients were included in our study. 58 patients were randomized in the STAND group and 56 patients in the PERSO group. After variance analysis on repeated measures of pain according to the PPMP-SF scale, we did not find any significant difference between the 2 groups (p = 0.284). 11.7% of patients had severe pain on the day of surgery and 4.9% on the following-day. There was no significant difference between the 2 groups about analgesic administration, rate of postoperative nausea, vomiting or fever. The median satisfaction rate about user-experience was 4/5.
Conclusion: We did not find any improvement in post tonsillectomy pain management by using Link4Life application in children in the PERSO group. It was difficult to reach our primary outcome in this series because of low postoperative pain level. There were no significant improvement in postoperative comfort since the surgical technique changed between 2015 and 2019 at the Fondation Lenval. Parents seem to underestimate children perioperative pain and anxiety. The parents satisfaction about home recovery was good. The post-operative follow-up application must continue to evolve in this direction.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02392079
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Marion Delacquis. Intérêt de l’utilisation d’une application pour smartphone dans l’optimisation du contrôle de la douleur après amygdalectomie chez l’enfant. Médecine humaine et pathologie. 2019. ⟨dumas-02392079⟩

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