Wel of geen intubatie bij adenotonsillectomie volgens Sluder? De veiligheid van adenotonsillectomie zonder endotracheale intubatie bij kinderen

Hester de Bruijn, Hà Ngo, Henk Blom, Tim van der Zwan, Leandra Boonman-de Winter, Gijs van Wermeskerken, Thijs Rettig

Research output: Contribution to journalArticleProfessional

Abstract

Objective
To determine the safety of the non-intubated and intubated adenotonsillectomy by the Sluder method in children

Design
Retrospective database study

Method
We compared the data of adenotonsillectomy by the Sluder method in children until thirteen years of two teaching hospitals from 2014 until 2017. In the Amphia Hospital the procedure was performed without endotracheal tube placement and without perioperative opioids, in the Haga Hospital the patients were intubated and received perioperative opioids. Primary outcome was reoperation for postoperative haemorrhage. Secondary outcomes included desaturation (saturation ≤ 90% > 1 min), severe hypoxemia (saturation ≤ 85% for ≥ 5 min), airway complications, bradycardia, total postoperative haemorrhages, use of rescue medication, hospital readmission and 30-day mortality.

Results
A total of 1370 patients were analysed: 1267 adenotonsillectomies and 103 tonsillectomies. Median operation time was 7 minutes in the non-intubated group versus 12 minutes in the intubated group. The primary outcome occurred in thirteen patients in the group without intubation (2.2%) and eleven times in the group with intubation (1.4%). There was one case of severe hypoxemia in the group without intubation. Desaturation occurred mostly in the group without intubation (26.4%) for a short time (median 0 min, interquartile range 0-1). Bradycardia was seen more in the group with intubation (4.1% vs 2.2%).

Conclusion
The incidence of postoperative haemorrhage and severe airway complications after adenotonsillectomy by the Sluder method with and without endotracheal tube placement in both groups was comparable.
Original languageDutch
JournalNederlands Tijdschrift voor Geneeskunde
Publication statusPublished - 24 May 2021
Externally publishedYes

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