The Effect of Around-The-Clock (ATC) Analgesic Administration on the Quality of Sleep and Behavioral Changes in Children after Surgery: A Randomized Clinical Trial

Introduction: Lack of effective control in postoperative pain can cause sleep disturbance, decreased fluid intake and incidence of behavioral changes, such as restlessness, irritability and reduced activity and play. Therefore, this study was performed with the aim of determining the effectiveness of Around-The-Clock (ATC) analgesic administration on the quality of sleep and behavioral changes in children after surgery. Methods: In this clinical trial, 68 children, 6 to 12 years old, admitted for tonsillectomy with one parent, were selected and randomly divided to control and case groups. For the case group, an intervention was performed by the Around-The-Clock (ATC) analgesic administration training after discharge. The data collection tool was a home dairy that was completed by parents. Data were analyzed with SPSS 16 by repeated measures, post-hoc, independent t and chi-square tests. Results: According to the independent t test, there were significant differences between children of case and control groups in average sleep quality scores on the first day after discharge (P = 0.008). According to chi-square test, except for appetite (P = 0.00), no significant differences were shown between children of the two groups in the other behavioral changes. Conclusions: Training of Around-The-Clock (ATC) analgesic administration in the first three days after ambulatory surgery, such as tonsillectomy, could prevent inappropriate behavioral changes in children and increase the quality of their sleep and appetite.