Perioperative management of sickle cell disease children undergoing adenotonsillectomy

Otolaryngol Head Neck Surg. 2006 Mar;134(3):370-3. doi: 10.1016/j.otohns.2005.11.001.

Abstract

Objective: To determine if outpatient tailored perioperative management has the same complication rate as that previously published for sickle cell disease (SCD) children who undergo adenotonsillectomy.

Study design and setting: Retrospective chart review of SCD children who underwent tonsillectomy with outcome measures of perioperative management and postsurgical complications.

Results: Of 41 patients, 61% were monitored for <24 hours with the average length of stay being 2 days (range, 1 to 10). Postoperative complications were noted in 9 (22%) patients, including 8 (20%) with hypoxia, 4 (10%) fever, 3 (8%) acute chest syndrome, and 1 (2.4%) airway fire, which are similar to the published literature.

Conclusions: Current literature supports extensive perioperative management with hospital stays averaging 3 to 5 days. These data demonstrate that the majority of these patients can be managed with <24-hour hospitalization stays with similar complication rates as previously described in the literature.

Significance: This study establishes a new paradigm for perioperative management of SCD children who undergo adenotonsillectomy.

Ebm rating: C-4.

MeSH terms

  • Adenoidectomy* / adverse effects
  • Adolescent
  • Ambulatory Surgical Procedures
  • Anemia, Sickle Cell / complications*
  • Blood Transfusion / methods
  • Child
  • Child, Preschool
  • Fever / etiology
  • Humans
  • Hypoxia / etiology
  • Length of Stay
  • Lung Diseases / etiology
  • Perioperative Care*
  • Postoperative Complications
  • Retrospective Studies
  • Syndrome
  • Tonsillectomy* / adverse effects
  • Treatment Outcome