Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults

Chung, Justin E R E Wong; Geet, Rozemarie van; Helmond, Noud van; Kastoer, Chloé; Böhringer, Stefan; Hout, Wilbert B. van den; Verschuur, H. P.; Peek, Ferdinand A W; Dammeijer, Patrick F. M.; Wermeskerken, Gijs K. A. van; Benthem, Peter Paul G. van; Blom, H. M.

doi:10.1001/jamanetworkopen.2021.48655

Cited by 6 publications

(2 citation statements)

References 38 publications

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“…Moreover, general anesthesia is mostly chosen for this type of surgery, and the location of the surgery is the pharynx; consequently, the incidence of postoperative sore throat, cough, hoarseness, bleeding and PONV is higher in pediatric patients. 10,[19][20][21][22] To prevent and mitigate these adverse effects and provide comfort medical care, many scholars have conducted studies and engaged in discussions from different perspectives, all of which have achieved some success and have been applied in clinical practice; however, each approach has its own advantages, disadvantages, and limitations. Therefore, how to prevent and reduce intubation and extubation reactions during pediatric tonsillectomy and adenoidectomy, improve postoperative pharyngeal comfort, and better achieve "comfort medical treatment" is still a hot spot in clinical anesthesia research, which is also one of the objectives of this study.…”

Section: Discussionmentioning

confidence: 99%

“…We attempted to reduce postoperative pain, decrease the incidence of pharyngeal‐related complications, and improve postoperative pharyngeal comfort by applying lidocaine aerosol in the pharynx to meet the concept of “comfort medical treatment.” Pediatric patients have a special constitution, low immunity, and underdeveloped pharyngeal organs and functions, which make them more reactive to intubation and extubation reactions and more sensitive to pain than adults. Moreover, general anesthesia is mostly chosen for this type of surgery, and the location of the surgery is the pharynx; consequently, the incidence of postoperative sore throat, cough, hoarseness, bleeding and PONV is higher in pediatric patients 10,19–22 . To prevent and mitigate these adverse effects and provide comfort medical care, many scholars have conducted studies and engaged in discussions from different perspectives, all of which have achieved some success and have been applied in clinical practice; however, each approach has its own advantages, disadvantages, and limitations.…”

Section: Discussionmentioning

confidence: 99%

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Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial

Cheng,

Zhang,

et al. 2023

Health Science Reports

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Background and AimsThe use of lidocaine aerosol for pediatric tonsil and adenoidectomy has been reported less frequently. We hope to improve the perioperative comfort of pediatric patients undergoing these procedures by applying lidocaine aerosol.MethodsA total of 122 pediatric patients receiving tonsil and adenoidectomy were randomly divided into a lidocaine aerosol group (Group L) and a saline group (Group C), with 61 patients in each group; 2.4% alkaline lidocaine aerosol and saline were sprayed in the pharynx before induction. Our primary outcome were the incidence and rate ratio (RR) of postoperative pharyngeal complications (oropharyngeal dryness, dysphagia, hoarseness, and sore throat) and the pharyngeal comfort score, the latter of which was assessed by the occurrence of the above complications (yes = 0 point, none = 1 point). The secondary outcomes included preoperative and intraoperative blood pressure and heart rate, the incidence of choking during the induction period, the intraoperative opioid dosage, and the pain level and depth of sedation at 2, 6, and 24 h postoperatively. Statistical software used in this study included PASS15.0, SPSS 26.0, and GraphPad Prism 9.3.1, and statistical methods used included the t‐test, the χ² test, the Mann–Whitney U test, and the repeated measures analysis of variance.ResultsThe incidence and RR of postoperative pharyngeal complications such as oropharyngeal dryness (RR: 0.667, 95% confidence interval [CI]: 0.458–0.970, p = 0.03), dysphagia (RR: 0.333, 95% CI: 0.114–0.976, p = 0.03), hoarseness (RR: 0.647, 95% CI: 0.433–0.967, p = 0.03), and sore throat (RR: 0.727, 95% CI: 0.547–0.967, p = 0.03) were significantly lower in Group L than in Group C at 2 h postoperatively, and the incidence and RR of postoperative sore throat was significantly lower in Group L than in Group C at 6 h postoperatively (RR: 0.717, 95% CI: 0.547–0.942, p = 0.01). The postoperative pharyngeal comfort scores were significantly higher in Group L than in Group C at all postoperative time points (p < 0.05). The Ramsay sedation score was significantly higher (p < 0.01) and FLACC (face, legs, activity, crying, and consolability) score was significantly lower (p < 0.01) in Group L than in Group C at 2 h postoperatively. In Group C, the blood pressure and heart rate significantly faster at all time points immediately after intubation and afterward, except at the end of surgery (p < 0.05).ConclusionsIn pediatric tonsil and adenoidectomy, the application of lidocaine aerosol before induction can reduce the incidence of postoperative pharyngeal complications, improve the child's postoperative pharyngeal comfort, and better realize perioperative “comfort medical treatment.”

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial

Cheng,

Zhang,

et al. 2023

Health Science Reports

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2022

JAMA Netw Open

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Transient Facial Nerve Palsy as a Complication of Local Anesthesia After Tonsillectomy

et al. 2023

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Chronic tonsillitis is a common otolaryngological disease worldwide. The treatment of choice is tonsillectomy, which is one of the most frequently performed procedures in Ear, Nose and Throat Departments. As with any surgical procedure, there are possible complications. Among them, rarely encountered and reported mainly in the pediatric population, is a short-term, transient facial nerve palsy resulting from local anesthetic administration. Here, we present a rare case of a 20-year-old woman with recurrent angina, who developed short-term, fully transient peripheral facial nerve palsy immediately after tonsillectomy under local anesthesia.

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Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults

Abstract: IMPORTANCE Carbon dioxide laser tonsillotomy performed under local anesthesia may be an effective and less invasive alternative than dissection tonsillectomy for treatment of tonsil-related afflictions.

Cited by 6 publications

References 38 publications

Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial

Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial

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Transient Facial Nerve Palsy as a Complication of Local Anesthesia After Tonsillectomy

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