Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ADENOIDECTOMY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMed2000

The feasibility of pain treatment at home after adenoidectomy with ketoprofen tablets in small children.

In this study, we investigated the feasibility of pain treatment using ketoprofen 25 mg tablets (5 mg x kg(-1) x day(-1)) at home in children after daycase adenoidectomy. We also determined the adverse events and the incidence of postoperative bleeding during the first week after surgery. Initially, we studied 611 children aged 1-9 years. The study design was prospective, longitudinal, and open. The final data consisted of 555 (91%) children, and 522 children who received ketoprofen at home. The parents administered four (1-10, median with 10th and 90th percentiles) ketoprofen tablets to their children during the first week. A total of 20% of the parents experienced problems in administering tablets, and problems were three times more common in children under 48 months compared to older children. The main problems were swallowing difficulties and the unpleasant taste of the tablet. Neither serious adverse events, nor clinically significant bleeding occurred. Ketoprofen at the dose of 5 mg x kg(-1) x day(-1) proved to be a safe analgesic in children for short-term use after adenoidectomy.

Adenoidectomy↗
PubMed2001

Perioperative intravenous ketoprofen neither prolongs operation time nor delays discharge after adenoidectomy in children.

Because nonsteroidal anti-inflammatory drugs, such as ketoprofen, prolong bleeding time, their preoperative administration may both prolong operation time and delay discharge. Therefore, charts of 335 children who had undergone adenoidectomy were evaluated to determine the effect of ketoprofen on operation time (OPERTIME) and length of hospital stay (ACTUAL LOS). The study was conducted in three phases (I-III) which differed from each other in the dose of i.v. ketoprofen, 0.3-3 mg x kg(-1). All phases were conducted with parallel groups using a prospective, randomized, and double blind design; moreover, phases I and III were placebo-controlled. OPERTIMEs were similar between Placebo groups and Ketoprofen groups. The dose of ketoprofen did not affect OPERTIME or ACTUAL LOS. In phase I, ACTUAL LOS was significantly longer in the Placebo group (251 +/- 46 min, mean +/- SD) compared to the Ketoprofen group (225 +/- 44 min, P=0.006). In conclusion, preincisional ketoprofen did not prolong OPERTIME or delay discharge in children undergoing adenoidectomy.

Adenoidectomy↗
PubMed2002

Analgesia for paediatric tonsillectomy and adenoidectomy with intramuscular clonidine.

BACKGROUND: After undergoing tonsillectomy and adenoidectomy (T&A), children may experience significant pain. Clonidine, an alpha2 agonist, exhibits significant analgesic properties. The current investigation sought to determine whether intramuscular (I.M.) clonidine would decrease pain in paediatric patients undergoing T&A. METHODS: Thirty-nine children undergoing elective T&A were studied. Following inhalational anaesthetic induction, fentanyl (2 microg x kg(-1)) was given intravenously, acetaminophen (paracetamol) (30 mg.kg-1) was given rectally and the children then randomly received an i.m. injection of either normal saline or clonidine (2 microg x kg(-1)). Perioperative analgesic requirements in the postanaesthesia care unit and at home following hospital discharge were evaluated. RESULTS: There were no significant demographic, analgesic consumption, haemodynamic or pain score differences between the groups. CONCLUSIONS: We do not recommend adding i.m. clonidine (2 microg x kg(-1)) to the analgesic regimen of children undergoing tonsillectomy and adenoidectomy.

Acetaminophen↗
PubMed2001

Molecular typing of paired bacterial isolates from the adenoid and lateral wall of the nose in children undergoing adenoidectomy: implications in acute rhinosinusitis.

OBJECTIVE: Recent studies have suggested that the origin of bacteria that enter the lateral wall of the nose and paranasal sinuses arise from the nasopharynx. The purpose of this study was to compare the molecular biological profiles of potential pathogens found in the nasopharynx and lateral wall of the nose concomittantly in children undergoing surgery for upper respiratory tract disease. STUDY DESIGN AND SETTING: Fifty-two children undergoing adenoidectomy for either tonsillectomy or adenoidectomy (hypertrophy) or otitis media with effusion were studied. Bacterial cultures were taken from the crypts of the adenoids and from the lateral wall of the nose under endoscopic control after sterilization of the vestibule and inferior turbinate. Routine cultures of these areas were performed in the bacteriology laboratory of the Children's Hospital of Buffalo. RESULTS: Bacterial pathogens were isolated from 79% of adenoids and 46% of lateral walls of the nose. Molecular typing of pairs of nontypable Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis revealed that in 16 of 18 pairs (89%) the identical strain was present in both sites simultaneously. CONCLUSIONS: These results support the concept that when potential bacterial pathogens that may cause acute bacterial rhinosinusitis are found concomitantly in the nasopharynx and lateral wall of the nose, they are usually identical.

Acute Disease↗
PubMed2002

The case for an outpatient "approach" for all pediatric tonsillectomies and/or adenoidectomies: a 4-year review of 1419 cases at a community hospital.

OBJECTIVE: We sought to document the safety and efficacy of approaching all pediatric tonsillectomies and/or adenoidectomies (T/A) as outpatient procedures. STUDY DESIGN AND SETTING: We conducted a 4-year retrospective study of 1419 pediatric patients undergoing T/A at an outpatient center with procedures performed by a single group of surgeons. RESULTS: None of the 593 patients undergoing an adenoidectomy and only 5 (0.6%) of those having a tonsillectomy had significant bleeding postoperatively. There were no readmissions for airway problems. Children younger than age 3 were most likely to have complications and to be held for overnight observations. CONCLUSIONS: Most children can be safely discharged after T/A. The higher incidence of perioperative complications in children who are younger than 3 years of age paralleled their higher rate of overnight observation. SIGNIFICANCE: Children less than 3 years of age require more careful observation, especially after tonsillectomy and more likely will need to be observed overnight than older children.

Adenoidectomy↗
PubMed2006

Adjuvant local anaesthetics in the epipharyngeal space in day-case adenoidectomy: a prospective, randomized, double-blind, placebo-controlled trial.

CONCLUSION: Mepivacaine applied in the epipharyngeal space as an adjuvant local anaesthetic does not reduce postoperative pain after adenoidectomy in children given high-dose paracetamol preoperatively. OBJECTIVE: To evaluate the pain-reducing effect of an adjuvant local anaesthetic (mepivacaine) applied in the epipharyngeal space after outpatient adenoidectomy. MATERIAL AND METHODS: This was a prospective, randomized, double-blind, placebo-controlled trial. Postoperative pain was assessed in 98 children aged 3-10 years using a visual analogue scale (VAS) and the Wong-Baker FACES pain rating scale. The time between the end of surgery and discharge from hospital was recorded, as well as the need for extra pain medication in addition to the high-dose paracetamol (acetaminophen) that had been given preoperatively. Serum levels of mepivacaine were analysed in 10 consecutive patients. RESULTS: No difference was seen between the mepivacaine and control groups regarding postoperative pain as estimated using either the VAS or the Wong-Baker FACES pain rating scale. There were also no differences between the groups concerning the time to discharge from hospital and the need for extra pain medication before discharge. No mepivacaine could be detected in the patients' sera.

Adenoidectomy↗
PubMed2001

Chlamydia pneumoniae in children undergoing adenoidectomy.

UNLABELLED: Chlamydia pneumoniae is a common respiratory pathogen which is often found in paediatric populations. Little is known about the true colonization rate and the localization of the bacteria in the respiratory tract. In this study, immunohistochemistry was used to examine adenoids from 69 children undergoing elective adenoidectomy. Throat swabs for polymerase chain reaction (PCR) and blood samples for serology were also obtained. Chlamydia pneumoniae was demonstrated in the adenoids by immunohistochemistry in 68 of the children. Five children (7%) had a positive C. pneumoniae PCR test from throat swabs and 14 children (20%) had detectable antibodies by the microimmunofluorescence technique. CONCLUSION: The results suggest that C. pneumoniae is a common finding in the adenoids of children undergoing adenoidectomy. Whether or not C. pneumoniae plays a pathogenic role in this patient population could not be determined from the data obtained in this investigation.

Adenoidectomy↗
PubMed1998

Changes in day care attendance rates and in the occurrence of adenoidectomies and tympanostomies.

The care of a child in a day care center is a marked risk factor for acute otitis media. In a nationwide questionnaire survey we found that the rate of tympanostomies and adenoidectomies was 59-67% higher for the children cared for at a day care center before the age of 3 y. When the local authorities in Finland at the beginning of 1990 were obliged by law to arrange day care for all children under 3 y, the number of adenoidectomies performed on children at this age increased by 30%.

Adenoidectomy↗
PubMed1983

Ventricular arrhythmia or supraventricular arrhythmia with aberrant conduction? An electrocardiographic study in halothane-anaesthetized children undergoing adenoidectomy.

The electrocardiograph (ECG) was recorded continuously in 20 children undergoing adenoidectomy during halothane anaesthesia. Five surface ECG leads and an oesophageal lead were used. In 11 children, there were QRS complexes which had a shape distinctly different from that of the ordinary sinus-evoked beats. Except in one child, these anomalous QRS complexes first made their appearance during surgery, although the arrhythmia continued until 0-1 min after adenoidectomy in some children. The severity ranged from that of occasional anomalous QRS complexes with uniform shape to that of a fast irregular rhythm with a variety of QRS shapes. Although the anomalous QRS complexes were premature, P waves and P-P intervals were unchanged. In some children, there appeared to be ventricular capture beats and fusion beats. Because of this, and in view of evidence gathered from studies in animals, by other authors, we considered it likely that the anomalous beats were ventricular in origin.

Adenoidectomy↗
PubMed1998

I.v. intraoperative ketoprofen in small children during adenoidectomy: a dose-finding study.

We have investigated if a low dose of ketoprofen (0.3 mg kg-1) i.v., provided as good analgesia with less adverse effects than higher doses (1.0 and 3.0 mg kg-1) in 220 children, aged 1-7 yr, undergoing adenoidectomy, in a prospective, randomized, double-blind, placebo-controlled, parallel group study. The postoperative analgesic effect was notable even after the lowest dose of ketoprofen. However, the higher doses seemed to provide better analgesia with no increase in adverse events or intraoperative bleeding. None of the children experienced postoperative bleeding which would have required intervention or delayed discharge from hospital. This study confirms the efficacy and safety of intraoperative ketoprofen in children during adenoidectomy.

Adenoidectomy↗
PubMed1996

Vomiting and recovery after outpatient tonsillectomy and adenoidectomy in children. Comparison of four anesthetic techniques using nitrous oxide with halothane or propofol.

BACKGROUND: The authors' purpose in this study was to compare prospectively four different anesthetic induction and maintenance techniques using nitrous oxide with halothane and/or propofol for vomiting and recovery after outpatient tonsillectomy and adenoidectomy procedures in children. METHODS: Eighty unpremedicated children, aged 3-10 yr, were assigned randomly to four groups: group H/H, 0.5-2% halothane induction/halothane maintenance; group P/P, 3-5 mg.kg-1 propofol induction and 0.1-0.3 mg.kg-1.min-1 propofol maintenance; group H/P, 0.1-0.3 mg.kg-1.min-1 halothane induction/propofol maintenance; and group P/H, 3-5 mg.kg-1 propofol induction and 0.5-2% halothane maintenance. Nitrous oxide (67%) and oxygen (33%) were administered in all the groups. Other treatments and procedures were standardized intra- and postoperatively. Results of postoperative vomiting and recovery were analyzed in the first 6 h and beyond 6 h. RESULTS: Logistic regression showed that vomiting occurred 3.5 times as often when halothane was used for maintenance of anesthesia (groups H/H and P/H) compared with the use of propofol (groups P/P and H/P; Odds Ratio 3.5; 95% confidence interval 1.3 and 9.4, respectively; P = 0.012). A significant association between vomiting ( < 6 h: yes/no) and discharge times ( > 6 h: yes/no) (Odd's Ratio = 3.6; 95% confidence interval: 1.02, 12.4, respectively) (P = 0.046) was shown. However, no significant differences among the groups in the incidence of vomiting beyond 6 h, recurrent vomiting, or hospital discharge times were shown. CONCLUSIONS: After tonsillectomy and adenoidectomy procedures, despite reduced postoperative vomiting with use of propofol rather than halothane, along with nitrous oxide for anesthetic maintenance, the authors found no differences in "true" endpoints such as unplanned admissions or discharge times. Among the groups, the main factor that delayed hospital discharge beyond 6 h was vomiting within the first 6 h.

Adenoidectomy↗
PubMed1999

Effects of anticholinergics on postoperative vomiting, recovery, and hospital stay in children undergoing tonsillectomy with or without adenoidectomy.

BACKGROUND: Nausea and vomiting are the most frequent problems after minor ambulatory surgical procedures. The agents used to induce and maintain anesthesia may modify the incidence of emesis. When neuromuscular blockade is antagonized with anticholinesterases, atropine or glycopyrrolate is used commonly to prevent bradycardia and excessive oral secretions. This study was designed to evaluate the effect of atropine and glycopyrrolate on postoperative vomiting in children. METHODS: Ninety-three patients undergoing tonsillectomy with or without adenoidectomy were studied. After inhalation induction of anesthesia with nitrous oxide, oxygen, and halothane, anesthesia was maintained with a nitrous oxide-oxygen mixture, halothane, morphine, and atracurium. Patients were randomized to receive, in a double-blinded manner, either 15 microg/kg atropine or 10 microg/kg glycopyrrolate with 60 microg/kg neostigmine to reverse neuromuscular blockade. Patient recovery, the incidence of postoperative emesis, antiemetic therapy, and the duration of postoperative hospital stay were assessed. RESULTS: There were no significant differences in age, gender, weight, or discharge time from the postanesthesia care unit or the hospital between the groups. Twenty-four hours after operation, the incidence of vomiting in the atropine group (56%) was significantly less than in the glycopyrrolate group (81%; P<0.05). There was no significant difference between the atropine and glycopyrrolate groups in the number of patients who required antiemetics or additional analgesics. CONCLUSIONS: In children undergoing tonsillectomy with or without adenoidectomy, reversal of neuromuscular blockade with atropine and neostigmine is associated with a lesser incidence of postoperative emesis compared with glycopyrrolate and neostigmine.

Adenoidectomy↗
PubMed1980

Adenoidectomy for middle ear disorders: a randomized controlled trial.

Repeated tympanometric screening of a regionally defined population of 3-year-old children defined a group of 42 children with middle ear disease which had persisted for at least 6 months. These children were treated by either myringotomy with adenoidectomy or myringotomy without adenoidectomy decided by random allocation. Postoperative observation during 6 months failed to disclose any difference in middle ear status between the two groups.

Adenoidectomy↗
PubMed1985

The effect of adenoidectomy on secretory otitis media: a 2-year controlled prospective study.

Seventy-eight preschool children considered to be suffering from long-standing secretory otitis media on the basis of a combination of impaired or abolished mobility of the tympanic membrane and conductive deafness, were examined consecutively. All children underwent bilateral paracentesis. Those children whose ears contained mucous secretion subsequently constituted a prospective longitudinal study group. On the same occasion as the paracentesis was performed, 24 children with bilateral or unilateral mucous secretion in their ears underwent adenoidectomy. Thirty-five non-adenoidectomized children with mucous secretion in one or both ears served as controls. Both groups were followed up for 24 months. At the end of this period they were compared with respect to the state and mobility of the eardrum, a pure tone average audiogram and middle ear impedance. No difference was detected between the two groups. It is therefore concluded that the preventive and therapeutic effects of adenoidectomy on secretory otitis media are doubtful.

Acoustic Impedance Tests↗
PubMed1991

Acoustic rhinometry, used as a method to demonstrate changes in the volume of the nasopharynx after adenoidectomy.

Acoustic rhinometry is a method of investigating the geometry of the nasal cavity and the nasopharynx. An acoustic impulse is transferred to the nasal cavity and the reflected signal is analysed expressing the cross-sectional area in the nasal cavity and the nasopharynx as a function of the distance from the nostril. The method provides an accurate and objective measurement of the geometry of the nasal cavity and the nasopharynx in a non-invasive way. In a series of 20 children, age range 4-16 years, it has been possible to demonstrate the changes in the volume of the nasopharynx after adenoidectomy. The relation between the volume of the adenoid and the calculated change of volume in the nasopharynx is found to be proportional and highly significant (P = 0.0005). It is concluded that acoustic rhinometry, which is very easy to perform, gives a reliable, objective measurement of the amount of adenoid tissue in the nasopharynx. The results from these and future studies may help reduce the number of unnecessary adenoidectomies.

Adenoidectomy↗
PubMed1993

An audit of the complications of paediatric tonsillectomy, adenoidectomy and adenotonsillectomy.

Tonsillectomy, adenoidectomy and adenotonsillectomy are among the commonest surgical procedures undertaken in children. The notes of 413 consecutive children having tonsillectomy, adenoidectomy or adenotonsillectomy were analysed retrospectively to determine complication rates. Of the total number of children, 5.6% had at least one complication, the most common of which was haemorrhage occurring as a first complication in 3.9% (16 children). Three children with bleeding required active treatment (0.7%), one requiring transfusion and two requiring a return to theatre, all within 3 1/2 hours of operation. The incidence of reactionary bleeding was not associated with the grade or seniority of the surgeon. Six children (1.5%) developed a fever post-operatively, of which one required antibiotic treatment. On the basis of these results it is feasible for such procedures to be carried out on a day-care basis.

Adenoidectomy↗
PubMed2005

The efficacy of a subhypnotic dose of propofol in preventing laryngospasm following tonsillectomy and adenoidectomy in children.

BACKGROUND: Laryngospasm is a well-known problem typically occurring immediately following tracheal extubation. Propofol is known to inhibit airway reflexes. In this study, we sought to assess whether the empiric use of a subhypnotic dose of propofol prior to emergence will decrease the occurrence of laryngospasm following extubation in children. METHODS: After approval from the Institutional Ethics Committee and informed parental consent, we enrolled 120 children ASA physical status I and II, aged 3-14 years who were scheduled to undergo elective tonsillectomy with or without adenoidectomy under standard general anesthesia. Before extubation, the patients were randomized and received in a blinded fashion either propofol 0.5 mg.kg(-1) or saline (control) intravenously. Tracheal extubation was performed 60 s after administration of study drug, when the child was breathing regularly and reacting to the tracheal tube. RESULTS: Laryngospasm was seen in 20% (n = 12) of the 60 children in the control group and in only 6.6% (n = 4) of 60 children in the propofol group (P < 0.05). CONCLUSIONS: During emergence from inhalational anesthesia, propofol in a subhypnotic dose (0.5 mg.kg(-1)) decreases the likelihood of laryngospasm upon tracheal extubation in children undergoing tonsillectomy with or without adenoidectomy.

Adenoidectomy↗
PubMed1999

Effect of a logopedic instruction program after adenoidectomy on open mouth posture: a single-blind study.

The effect of adenoidectomy (controls) on habitual open mouth posture was compared with adenoidectomy in combination with a logopedic instruction program (cases). One hundred and fifty-nine children were included (aged 2-10 years, mean age 4.6 years). The instruction program consisted of three individual logopedic sessions at 1 week, 2 weeks and 4 weeks postoperatively. One week preoperatively, 2 months and 1 year postoperatively an estimation of open mouth posture was carried out. Two months postoperatively there was a significant difference between the two groups (p = 0.001), but 1 year postoperatively this difference had disappeared (p = 0.526). The logopedic instruction program was not effective for the youngest age-group (<3.6 years).

Adenoidectomy↗