Measurement of Blood Loss during Adenotonsillectomy in Children and Factors Affecting It

Abstract

This prospective study was done at the Southern Railway Headquarters Hospital, Ayanavaram, Chennai to measure the intraoperative blood loss during adenotonsillectomy and to assess the factors affecting it. Since blood volume in children is low, even a small loss will result in dreaded complications, so blood loss measurement in paediatric surgery is important. Adenotonsillectomy is the most common surgery performed in the field of otolaryngology, so blood loss measurement is essential in this surgery. In the study, 50 children who underwent adenotonsillectomy, by conventional dissection and snare method for tonsillectomy and curette method for adenoidectomy, were evaluated for operative blood loss. This study was conducted over a 1 year period, from June 2013 to June 2014. Both gravimetric method and blood volume studies were used to measure the operative blood loss. The estimated blood loss by gravimetric method was 94.35 ml, whereas the actual blood loss by blood volume studies was 90.57 ml and the average blood loss was 92.46 ml. The youngest child who was operated was 4 years old and the oldest child was 15 years old. The minimum blood loss was 40.30 ml and the maximum was 278.46 ml. In our series, operative blood loss was dependent on fibrosis of tonsil and the grade of the tonsil. There was no significant correlation between age and sex of the patient and the surgical skills.

Sangrado intraoperatorio de amigdalectomía en población pediátrica. Influencia de factores quirúrgicos y anestésicos

“…La literatura con respecto al sangrado intraoperatorio es limitada. En 1965, Holden et al, estimó dicho sangrado en 128,1 ml en pacientes de 4 a 12 años [7], mientras que estudios más recientes sugieren 92,46 ml [8] y 73,7-79,8 ml en pacientes de 4 a 9 años [9]. A pesar de ser potencialmente severo, la tasa de transfusión asociada al sangrado intraoperatorio se mantiene baja (0%-3%), y a menudo se ve relacionada con alteraciones de la coagulación [10], [11].…”