Prolonged recovery after out-patient pediatric adenotonsillectomy

Jaryszak, Eric M.; Lander, Lina; Patel, Anju K.; Choi, Sukgi S.; Shah, Rahul K.

doi:10.1016/j.ijporl.2011.01.024

“…Many outpatient facilities have used information from their research as the basis for their postoperative care, but since 1987, several other studies have looked into whether such a long recovery time is necessary for every patient. 2,[7][8][9][10] Currently, the majority of patients admitted following tonsillectomy are children under 2 years, patients with OSA due to concern of postoperative respiratory depression, or patients with at least 1 medical co-morbidity. 11 A 1999 retrospective chart review of 143 patients determined that an average recovery time of 84 minutes would be enough to consider safe with a low rate of complications (4.1%) compared to the 6-hour limit at that time.…”

Section: Discussionmentioning

confidence: 99%

“…Discharge readiness for this study was operationalized by following the American Society of Perianesthesia Nurses (ASPAN) guidelines and the Modified Aldrete Scoring System. Both ASPAN guidelines and the Aldrete scoring system included key clinical indicators related to this surgical procedure: (1) written physician order for discharge; (2) adequate respiratory function consistent with preoperative baseline; (3) stable vital signs with normal temperature (36.5°C-38.5°C); (4) ambulation consistent with developmental age and preoperative status; (5) adequate level of consciousness consistent with admission assessment; (6) demonstration of fluid toleration with absence of nausea, vomiting, and coughing; (7) acceptable level of pain control with oral medication (ibuprofen, acetaminophen, and hydrocodone depending on age); and (8) no active bleeding from surgical site.…”

Section: Methodsmentioning

confidence: 99%

Using Clinical Indicators to Reduce Perianesthesia Recovery Time Following Outpatient Tonsillectomy

Zalzal

¹

,

Makary

²

,

Evans

³

et al. 2018

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

show abstract

“…Tonsillectomy is associated with a high incidence of postoperative pain (1-4) not only complicating the recovery but also delaying patients discharge (5). Painful throats make the patient agitated, delay oral intake and increase hospitalization and expenses (6, 7).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Low Dose Ketamine in Post Tonsillectomy Pain Relief: A Randomized Trial Comparing Intravenous and Subcutaneous Ketamine in Pediatrics

Javid¹,

Hajijafari²,

Hajipour³

et al. 2012

View full text Add to dashboard Cite

It is useful for the medical education fields and all who are interested in that.Background: Pain control in children is still a therapeutic dilemma. Preschool patients are affected from undesirable effects of postoperative pain more than adults. Tonsillectomy is associated with a high incidence of postoperative pain, not only complicating the recovery, but also delaying patients discharge. Objectives: Despite employing different surgical and anesthetic strategies in post-tonsillectomy pain relief, this is still a clinical problem. The study was designed to evaluate the efficacy of a low dose ketamine in post tonsillectomy pain relief. Patients and Methods: Our prospective randomized double blinded study enrolled 75 pediatric patients (3-10 years old) who were scheduled for a tonsillectomy procedure. Patients were randomly assigned to one of three groups receiving; intravenous (IV) ketamine 0.5mg/kg, subcutaneous (SC) ketamine 0.5 mg/kg and placebo at the end of the operation. Post-operative pain score was assessed using modified CHEOPS. Results: In our study we did not find any significant difference among the three groups regarding sex, age, and weight, duration of operation, hemodynamic stability, and nausea and vomiting. However, in ketamine groups, pain score and analgesic consumption were significantly lower (P < 0.00). The efficacy of the both ketamine groups was similar. Conclusions: The study demonstrated that the both subcutaneous and intravenous injections of ketamine, at the end of the operation, were safe and effective for post-tonsillectomy pain control. Ketamine reduced postoperative analgesic medications consumption without increasing the risk of complications.

show abstract

“…Tonsillectomy is associated with a high incidence of postoperative pain (1-4) not only complicating the recovery but also delaying patients discharge (5). Painful throats make the patient agitated, delay oral intake and increase hospitalization and expenses (6,7).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Low Dose Ketamine in Post Tonsillectomy Pain Relief: A Randomized Trial Comparing Intravenous and Subcutaneous Ketamine in Pediatrics

Javid¹,

Hajijafari²,

Hajipour³

et al. 2012

View full text Add to dashboard Cite

It is useful for the medical education fields and all who are interested in that.Background: Pain control in children is still a therapeutic dilemma. Preschool patients are affected from undesirable effects of postoperative pain more than adults. Tonsillectomy is associated with a high incidence of postoperative pain, not only complicating the recovery, but also delaying patients discharge. Objectives: Despite employing different surgical and anesthetic strategies in post-tonsillectomy pain relief, this is still a clinical problem. The study was designed to evaluate the efficacy of a low dose ketamine in post tonsillectomy pain relief. Patients and Methods: Our prospective randomized double blinded study enrolled 75 pediatric patients (3-10 years old) who were scheduled for a tonsillectomy procedure. Patients were randomly assigned to one of three groups receiving; intravenous (IV) ketamine 0.5mg/kg, subcutaneous (SC) ketamine 0.5 mg/kg and placebo at the end of the operation. Post-operative pain score was assessed using modified CHEOPS. Results: In our study we did not find any significant difference among the three groups regarding sex, age, and weight, duration of operation, hemodynamic stability, and nausea and vomiting. However, in ketamine groups, pain score and analgesic consumption were significantly lower (P < 0.00). The efficacy of the both ketamine groups was similar. Conclusions: The study demonstrated that the both subcutaneous and intravenous injections of ketamine, at the end of the operation, were safe and effective for post-tonsillectomy pain control. Ketamine reduced postoperative analgesic medications consumption without increasing the risk of complications.

show abstract

Prolonged recovery after out-patient pediatric adenotonsillectomy

Cited by 22 publications

References 15 publications

Using Clinical Indicators to Reduce Perianesthesia Recovery Time Following Outpatient Tonsillectomy

Using Clinical Indicators to Reduce Perianesthesia Recovery Time Following Outpatient Tonsillectomy

Evaluation of a Low Dose Ketamine in Post Tonsillectomy Pain Relief: A Randomized Trial Comparing Intravenous and Subcutaneous Ketamine in Pediatrics

Evaluation of a Low Dose Ketamine in Post Tonsillectomy Pain Relief: A Randomized Trial Comparing Intravenous and Subcutaneous Ketamine in Pediatrics

Contact Info

Product

Resources

About