[Adenotonsillectomy with or without intubation? Safety of the adenotonsillectomy without endotracheal tube in children].

Autor:	de Bruijn H; Amphia Ziekenhuis, afd. Anesthesiologie, Intensive Care en Pijngeneeskunde,Breda., Ngo H; Juliana Kinderziekenhuis, afd. Keel-Neus-Oorheelkunde, Den Haag., Blom HM; Juliana Kinderziekenhuis, afd. Keel-Neus-Oorheelkunde, Den Haag., van der Zwan T; Juliana Kinderziekenhuis, afd. Anesthesiologie, Den Haag., Boonman-de Winter LJM; Amphia Ziekenhuis, afd. Amphia Academie,Breda., van Wermeskerken GKA; Amphia Ziekenhuis, afd. Keel-Neus-Oorheelkunde,Breda., Rettig TCD; Amphia Ziekenhuis, afd. Anesthesiologie, Intensive Care en Pijngeneeskunde,Breda.; Contact: Thijs C.D. Rettig (trettig@amphia.nl).
Jazyk:	Dutch; Flemish
Zdroj:	Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2021 May 19; Vol. 165. Date of Electronic Publication: 2021 May 19.
Abstrakt:	Objective: To determine the safety of the non-intubated and intubated adenotonsillectomy by the Sluder method in children DESIGN: Retrospective database study METHOD: We compared the data of adenotonsillectomy by the Sluder method in children until thirteen years of two teaching hospitals from 2014 until 2017. In the Amphia Hospital the procedure was performed without endotracheal tube placement and without perioperative opioids, in the Haga Hospital the patients were intubated and received perioperative opioids. Primary outcome was reoperation for postoperative haemorrhage. Secondary outcomes included desaturation (saturation ≤ 90% > 1 min), severe hypoxemia (saturation ≤ 85% for ≥ 5 min), airway complications, bradycardia, total postoperative haemorrhages, use of rescue medication, hospital readmission and 30-day mortality. Results: A total of 1370 patients were analysed: 1267 adenotonsillectomies and 103 tonsillectomies. Median operation time was 7 minutes in the non-intubated group versus 12 minutes in the intubated group. The primary outcome occurred in thirteen patients in the group without intubation (2.2%) and eleven times in the group with intubation (1.4%). There was one case of severe hypoxemia in the group without intubation. Desaturation occurred mostly in the group without intubation (26.4%) for a short time (median 0 min, interquartile range 0-1). Bradycardia was seen more in the group with intubation (4.1% vs 2.2%). Conclusion: The incidence of postoperative haemorrhage and severe airway complications after adenotonsillectomy by the Sluder method with and without endotracheal tube placement in both groups was comparable.
Databáze:	MEDLINE
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