Tonsillectomy and adenoidectomy








K Tonsillectomy and adenoidectomy




1. Introduction

    Children may present for tonsillectomy or adenoidectomy with a history of recurrent infections (chronic tonsillitis) or a history of obstruction and sleep apnea.

2. Preoperative assessment and patient preparation
a) History and physical examination
(1) Cardiac: Echocardiography may be useful to determine the presence of right-sided heart failure from chronic airway obstruction. These patients are at increased risk for negative-pressure pulmonary edema and volume overload.

(2) Respiratory: Evaluate for potentially difficult airway management. If the child exhibits signs and symptoms of URI, there may be an increased risk of laryngospasm intraoperatively and postoperatively. The choice to cancel or proceed with surgery must be evaluated on an individual basis.

b) Patient preparation
(1) Judicious use of preoperative medication in children with obstructive apnea

(2) Midazolam, 0.5 mg/kg orally in children without obstruction

(3) Antisialagogue is strongly recommended

(4) Laboratory tests: As indicated by the history and physical examination

(5) Diagnostic tests: As indicated by the history and physical examination

3. Room preparation
a) Monitoring equipment: Standard

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Dec 2, 2016 | Posted by in ANESTHESIA | Comments Off on Tonsillectomy and adenoidectomy

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