Risks and benefits of local anesthesia versus general anesthesia in tonsillectomy

Matovinović, Filip; Bacan, Filip; Kereković, Elvira; Pegan, Alan; Rašić, Ivan

doi:10.1016/j.amjoto.2018.05.015

Cited by 6 publications

(8 citation statements)

References 12 publications

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“…The incidence rate was 11.9%. [2][3][4] Several studies have shown that such procedures have perioperative complications that may result in severe and persistent postoperative pain, bleeding, and a high frequency of postoperative nausea and vomiting (PONV). 5,6 Therefore, this type of surgery poses high requirements for performing general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

“…Chidren are more sensitive to pain, especially during tonsil and adenoidectomy, and postoperative swelling and pain in the pharynx cause agitation and crying in these pediatric patients, which can easily lead to bleeding from the surgical wound. The incidence rate was 11.9% 2–4 . Several studies have shown that such procedures have perioperative complications that may result in severe and persistent postoperative pain, bleeding, and a high frequency of postoperative nausea and vomiting (PONV) 5,6 .…”

Section: Introductionmentioning

confidence: 99%

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Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial

Cheng,

Zhang,

et al. 2023

Health Science Reports

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Background and AimsThe use of lidocaine aerosol for pediatric tonsil and adenoidectomy has been reported less frequently. We hope to improve the perioperative comfort of pediatric patients undergoing these procedures by applying lidocaine aerosol.MethodsA total of 122 pediatric patients receiving tonsil and adenoidectomy were randomly divided into a lidocaine aerosol group (Group L) and a saline group (Group C), with 61 patients in each group; 2.4% alkaline lidocaine aerosol and saline were sprayed in the pharynx before induction. Our primary outcome were the incidence and rate ratio (RR) of postoperative pharyngeal complications (oropharyngeal dryness, dysphagia, hoarseness, and sore throat) and the pharyngeal comfort score, the latter of which was assessed by the occurrence of the above complications (yes = 0 point, none = 1 point). The secondary outcomes included preoperative and intraoperative blood pressure and heart rate, the incidence of choking during the induction period, the intraoperative opioid dosage, and the pain level and depth of sedation at 2, 6, and 24 h postoperatively. Statistical software used in this study included PASS15.0, SPSS 26.0, and GraphPad Prism 9.3.1, and statistical methods used included the t‐test, the χ² test, the Mann–Whitney U test, and the repeated measures analysis of variance.ResultsThe incidence and RR of postoperative pharyngeal complications such as oropharyngeal dryness (RR: 0.667, 95% confidence interval [CI]: 0.458–0.970, p = 0.03), dysphagia (RR: 0.333, 95% CI: 0.114–0.976, p = 0.03), hoarseness (RR: 0.647, 95% CI: 0.433–0.967, p = 0.03), and sore throat (RR: 0.727, 95% CI: 0.547–0.967, p = 0.03) were significantly lower in Group L than in Group C at 2 h postoperatively, and the incidence and RR of postoperative sore throat was significantly lower in Group L than in Group C at 6 h postoperatively (RR: 0.717, 95% CI: 0.547–0.942, p = 0.01). The postoperative pharyngeal comfort scores were significantly higher in Group L than in Group C at all postoperative time points (p < 0.05). The Ramsay sedation score was significantly higher (p < 0.01) and FLACC (face, legs, activity, crying, and consolability) score was significantly lower (p < 0.01) in Group L than in Group C at 2 h postoperatively. In Group C, the blood pressure and heart rate significantly faster at all time points immediately after intubation and afterward, except at the end of surgery (p < 0.05).ConclusionsIn pediatric tonsil and adenoidectomy, the application of lidocaine aerosol before induction can reduce the incidence of postoperative pharyngeal complications, improve the child's postoperative pharyngeal comfort, and better realize perioperative “comfort medical treatment.”

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial

Cheng,

Zhang,

et al. 2023

Health Science Reports

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“…Studies have shown that local anesthesia effectively reduces duration of surgery; decreases postoperative pain, nausea, vomiting, and opioid consumption; and improves cost-effectiveness in orthopedic and minor day surgery. [1][2][3][4] Cleft palate repair contributes a considerable portion of all complications and costs in pediatric plastic surgery. 5,6 Although several studies have…”

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confidence: 99%

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confidence: 99%

A Nationwide Analysis of Cleft Palate Repair: Impact of Local Anesthesia on Operative Outcomes and Hospital Cost

Humphries

Zimmerman

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Local anesthesia is commonly used in a wide range of surgical operations, including plastic and reconstructive procedures, for both adult and pediatric patients. Studies have shown that local anesthesia effectively reduces duration of surgery; decreases postoperative pain, nausea, vomiting, and opioid consumption; and improves cost-effectiveness in orthopedic and minor day surgery. [1][2][3][4] Cleft palate repair contributes a considerable portion of all complications and costs in pediatric plastic surgery. 5,6 Although several studies have

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“…Останні дослідження вказують на потенційно корисну роль транексамової кислоти в запобіганні післяопераційної кровотечі при виконанні тонзилектомії [22,[25][26][27].…”

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Optimization of the approach to conducting tonsillectomy

Pukhlik

KOLESNICHENKO

2021

OTORHINOLARYNGOLOGY

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Actuality: Recurrent tonsillitis considers to be one of the most common ENT diseases. Tonsillectomy as the method of recurrent tonsillitis’ treatment is being performed as usual as 20% of all surgeries in ENT departments. The critical criteria for the success of tonsillectomy for the surgeon are the frequency of perioperative complications, long-term results of treatment, and the patient's recovery time. For the patient, those criteria are the severity of pain, psychoemotional stress, the time spent in the hospital, and how fast he can return to his daily life routine. The factors that significantly affect the outcome of tonsillectomy are the choice of anesthetic management and perioperative medical hemostatic support. Aim: Our study aimed to optimize the approach to carry out tonsillectomy by preoperative application of the tranexamic acid 10% solution and optimize the approach to choosing between endotracheal anesthesia and local anesthesia. Materials and methods: Clinical studies were made among 212 patients with recurrent tonsillitis who went through a bilateral tonsillectomy. The patients were divided into three groups. The 1st group included 54 patients undergoing tonsillectomy using endotracheal anesthesia with the administration of tranexamic acid at the rate of 10 mg/kg of body weight. The 2nd group consisted of 97 patients undergoing tonsillectomy using local anesthesia. A 3rd (control) group included 61 patient undergoing tonsillectomy using endotracheal anesthesia. The first and control (3rd) groups of patients were compared to assess the efficacy of using tranexamic acid.Factors such as the duration of the surgery, the amount of blood loss, intraoperative events, the number of incidents of primary and secondary bleeding, and laboratory data were considered. The second and control (third) groups were compared to evaluate the impact of anesthetic management. We considered the factors such as duration of surgery, the amount of blood loss, intraoperative events, number of incidents of primary and secondary bleeding, assessment of pain syndrome, necessity of analgesics administration, length of hospital stay, and recovery period. Conclusions: tonsillectomy surgery using local anesthesia requires less time to perform, has less blood loss, fewer intraoperative events, and lessincidents of primary and secondary bleeding. The average level of pain is higher in patients using endotracheal anesthesia. The use of tranexamic acid 10% significantly reduces the amount of blood loss, helps to reduce intraoperative complications, and lower the emergence of postoperative bleeding and its intensity.

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Risks and benefits of local anesthesia versus general anesthesia in tonsillectomy

Cited by 6 publications

References 12 publications

Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial

Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial

A Nationwide Analysis of Cleft Palate Repair: Impact of Local Anesthesia on Operative Outcomes and Hospital Cost

Optimization of the approach to conducting tonsillectomy

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