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Peritonsillar infiltration of lidocaine with adrenaline is associated with increased risk of secondary post-tonsillectomy haemorrhage

Published online by Cambridge University Press:  09 October 2018

H K Tolska ,
A J Takala  and
J Jero
H K Tolska*
Affiliation:
Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Finland
A J Takala
Affiliation:
Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Finland
J Jero
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Turku University Hospital, Finland
*
Author for correspondence: Dr Hanna Kaisa Tolska, Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Kasarmikatu 11–13, PO Box 263, 00029 HUS, Finland E-mail: kaisa.tolska@hus.fi
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Abstract

Objectives

In order to evaluate the safety of tonsillectomy among children, we retrospectively studied the incidence of post-operative complications, adverse events and their association with peri-operative medication.

Methods

Data were collected from the medical records of 691 patients aged 1–16 years, including details of post-operative complications (any unplanned contact with the hospital), analgesics, dexamethasone, 5-HT3 antagonists, local anaesthetic and haemostatic agents.

Results

Recovery was complicated in 13.6 per cent of patients, of whom 8.4 per cent were re-admitted to the ward. The most common complication was post-tonsillectomy haemorrhage, experienced by 7.1 per cent of patients. Re-operation under general anaesthesia (for grade III post-tonsillectomy haemorrhage) was required by 4.2 per cent of patients. Peritonsillar infiltration of lidocaine with adrenaline increased the risk of post-tonsillectomy haemorrhage (odds ratio = 4.1; 95 per cent confidence interval = 2.1 to 8.3).

Conclusion

Every seventh paediatric patient experienced a complicated recovery after tonsillectomy, caused by post-tonsillectomy haemorrhage in most cases. Local peritonsillar infiltration of lidocaine with adrenaline was associated with an increased risk of post-tonsillectomy haemorrhage.

Keywords

TonsillectomyNon-Steroidal Anti-Inflammatory AgentsDexamethasoneLidocaineAdrenaline
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 10 , October 2018 , pp. 911 - 922
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr H K Tolska takes responsibility for the integrity of the content of the paper

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