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Postoperative care after tonsillectomy: what's the evidence?
- Source :
-
Current opinion in otolaryngology & head and neck surgery [Curr Opin Otolaryngol Head Neck Surg] 2017 Dec; Vol. 25 (6), pp. 498-505. - Publication Year :
- 2017
-
Abstract
- Purpose of Review: The purpose of this review is to evaluate the current literature regarding postoperative management after tonsillectomy in children.<br />Recent Findings: Controversy remains regarding the ideal medication regimen to manage pain after tonsillectomy. Acetaminophen and ibuprofen are routinely used, although concerns of more severe postoperative hemorrhage with ibuprofen remain. Narcotics are prescribed commonly, but with extreme caution in children with severe obstructive sleep apnea. Although not always utilized by the authors, additional adjunctive medications such as perioperative dexamethasone, ketamine, and local infiltration of lidocaine into tonsillar pillars may decrease postoperative pain. Systematic reviews have shown that dexamethasone does not increase risk of posttonsillectomy bleeding.<br />Summary: Adenotonsillectomy is one of the most common procedures performed on children and may have significant morbidity from postoperative pain and bleeding. Managing pain remains challenging and the optimal treatment regimen has not been definitively identified. Many medications and alternative therapies have been studied and suggest possible benefit.
- Subjects :
- Adenoidectomy adverse effects
Adolescent
Child
Child, Preschool
Evidence-Based Medicine
Female
Humans
Male
Pain Management
Pain Measurement
Pain, Postoperative diagnosis
Postoperative Care methods
Postoperative Hemorrhage diagnosis
Risk Assessment
Tonsillectomy adverse effects
Treatment Outcome
Adenoidectomy methods
Pain, Postoperative drug therapy
Postoperative Hemorrhage therapy
Postoperative Nausea and Vomiting therapy
Tonsillectomy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1531-6998
- Volume :
- 25
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Current opinion in otolaryngology & head and neck surgery
- Publication Type :
- Academic Journal
- Accession number :
- 29028641
- Full Text :
- https://doi.org/10.1097/MOO.0000000000000420