The Effects of Maternal Presence During Anesthesia Induction on Salivary Cortisol Levels in Children Undergoing Tonsillectomy and/or Adenoidectomy

Ozdogan, H. K.; Cetinalp, S.; Kuran, G.; Tugal, O.; Tahiroglu, M.; HERDEM, Ümmühan EREN; Haytoglu, S.

doi:10.1097/sa.0000000000000335

Cited by 2 publications

(3 citation statements)

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“…23 additionally, parental presence may lead to reduced salivary cortisol levels during anesthesia induction as well as in recovery, which would indicate reduced stress in the patient. 24…”

Section: Discussionmentioning

confidence: 99%

“…23 additionally, parental presence may lead to reduced salivary cortisol levels during anesthesia induction as well as in recovery, which would indicate reduced stress in the patient. 24 Intraoperatively, 62.7% typically use IV acetaminophen for this population. There was early interest in using intraoperative IV acetaminophen to reduce postoperative pain in children.…”

Section: Discussionmentioning

confidence: 99%

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How Pediatric Anesthesiologists Manage Children with OSA Undergoing Tonsillectomy

Roberts

Sayegh

Ellison

et al. 2019

Ann Otol Rhinol Laryngol

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Objective: The purpose of this study was to describe typical anesthesia practices for children with obstructive sleep apnea (OSA). Study Design: Online survey. Method: A sample of pediatric anesthesiologists received the survey by email. Results: 110 respondents were included. 46.4% worked in a free-standing children’s hospital and 32.7% worked in a children’s facility within a general hospital. 73.6% taught residents. 44.4% saw at least one child with OSA per week, 25.5% saw them daily. On a 100-mm visual analog scale, respondents rated their comfort with managing these children as 84.94 (SD 17.59). For children with severe OSA, 53.6% gave oral midazolam preoperatively, but 24.5% typically withheld premedication and had the parent present for induction. 68.2% would typically use nitrous oxide for inhalational induction. 68.2% used fentanyl intraoperatively, while 20.0% used morphine. 61.5% reduced their intraop narcotic dose for children with OSA. 98.2% used intraoperative dexamethasone, 58.2% used 0.5 mg/kg for the dose. 98.2% used ondansetron, 62.7% used IV acetaminophen, and 8.2% used IV NSAIDs. 83.6% extubated awake. 27.3% of respondents stated that their institution had standardized guidelines for perioperative management of children with OSA undergoing adenotonsillectomy. People who worked in children’s hospitals, who had >10 years of experience, or who saw children with OSA frequently were significantly more comfortable dealing with children with OSA ( P < 0.05). Conclusion: Apart from using intraoperative dexamethasone and ondansetron, management varied. These children would likely benefit from best practices perioperative management guidelines.

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“…23 additionally, parental presence may lead to reduced salivary cortisol levels during anesthesia induction as well as in recovery, which would indicate reduced stress in the patient. 24…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How Pediatric Anesthesiologists Manage Children with OSA Undergoing Tonsillectomy

Roberts

Sayegh

Ellison

et al. 2019

Ann Otol Rhinol Laryngol

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“…The authors should be congratulated for performing a well-designed trial in an important topic for patients undergoing tonsillectomy surgery. 2,3…”

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confidence: 99%

Gabapentin to Prevent Acute Pain after Tonsillectomy

Kendall¹,

Castro-Alves²

2018

Otolaryngol.--head neck surg.

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We read with great interest the article of Sanders et al in a recent issue of the journal. 1 The authors examined 73 adults undergoing tonsillectomy and concluded that preemptive gabapentin (600 mg) resulted in greater postoperative pain scores and analgesic consumption following adult tonsillectomy when compared with placebo. The authors should be congratulated for performing a well-designed trial in an important topic for patients undergoing tonsillectomy surgery. 2,3 Although the study of Sanders et al was designed well, there are some concerns regarding their trial that should be clarified to determine the validity of the study findings. First, it would be important to present the postoperative opioid and nonopioid analgesic consumption by study groups, as this can significantly alter the primary outcome. 4,5 Second, although the authors listed the common drugs used during anesthesia, the anesthetic management was not standardized, and this can alter the primary outcome. Last, the authors evaluated 2 primary outcomes (pain at rest and swallowing) across 15 time points. The authors should have corrected their P values to avoid type I errors (Bonferroni-corrected P < .001). We welcome comments to address the aforementioned issues. This would help to further validate the findings of this important study.

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The Effects of Maternal Presence During Anesthesia Induction on Salivary Cortisol Levels in Children Undergoing Tonsillectomy and/or Adenoidectomy

Cited by 2 publications

References 0 publications

How Pediatric Anesthesiologists Manage Children with OSA Undergoing Tonsillectomy

How Pediatric Anesthesiologists Manage Children with OSA Undergoing Tonsillectomy

Gabapentin to Prevent Acute Pain after Tonsillectomy

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