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

: Tolska HK, Takala AJ, Jero J

Publisher: CAMBRIDGE UNIV PRESS

: 2018

: Journal of Laryngology and Otology

: JOURNAL OF LARYNGOLOGY AND OTOLOGY

: J LARYNGOL OTOL

: 132

: 10

: 911

: 922

: 12

: 0022-2151

: 1748-5460

DOI: https://doi.org/10.1017/S0022215118001731

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 readmitted 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.