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[Inhalational anesthesia during adenoidectomy in children].

The paper deals with the comparison of inhalational anesthesia using a fluoroethane-monooxide-oxygen mixture in apparatus-mask and endotracheal fashions in children during adenotomy. Children aged 4 to 15 years, who had undergone apparatus-mask (n = 51) and endotracheal (n = 57) anesthesia, were examined. The patients were divided into two age groups: 4-8 years and 8-15 years. The parameters of central hemodynamics, the data of cardiointervalograms, respiration rate, and SatO2 were studied. The studies were repeated 5 times for each patient at the stages of anesthesia and surgery. The use of inhalational fluroethane-monoxide-oxygen anesthesia in apparatus-mask and endotracheal fashions was found to be inadequate in children during adenotomy without addition of analgesics. In 4-8-year-old children, apparatus-mask fluoroethane-monooxide-oxygen anesthesia during surgery is ineffective, as shown by the data of central hemodynamics and cardiointervalography. The pain syndrome was observed in the postoperative period. Endotracheal fluoroethane-monooxide-oxygen anesthesia fails to ensure adequate analgesia during intubation and surgery. The pain syndrome and sympathicotony were seen in the postoperative period. In 8-15-year-old children, apparatus-mask fluoroethane-monooxide-oxygen anesthesia is characterized by prehypoxia and inadequate anesthesiological defense at the traumatic stage of an operation. In endotracheal fluoroethane-monooxide-oxygen anesthesia, the stability of cardiac output is maintained by the tension of more mature compensatory mechanisms responsible for regulation of central hemodynamics. A marked sympathicotony is noted at the traumatic stage of a surgery, as evidenced by cardiointervalography. There is motor agitation in the postoperative period.

Adenoidectomy↗
PubMed1990

Complications of outpatient tonsillectomy and adenoidectomy: a review of 3,340 cases.

Of the 3,340 T&A cases reviewed, 1.4% of the patients experienced major complications, including primary or delayed hemorrhage, anesthetic complications, severe nausea, and dehydration. Less than 1% (0.5%) required hospital admissions. Only 5 patients (0.15%) were identified as patients who would have been in the hospital at the time the complication occurred if all T&A patients had been hospitalized for 48 hours postoperatively. Although this rate of occurrence for complications should not be ignored, it is the opinion of the authors that it is a risk level low enough to be well within acceptable limits for outpatient operations. The trend toward outpatient procedures is one that will undoubtedly grow not only because of the advances in medical technology, which enable the provision of better and safer medical care, but also because of the economic considerations in today's health care world. Currently, the medical profession is in a period of transition to determine which surgical procedures are appropriate for outpatient treatment. As physicians, our concern to provide safe, rational therapy to our patients must preclude all other considerations. Our retrospective case review supports the concept that patients who require T&A, when properly evaluated, can have safe operations on an outpatient basis.

Adenoidectomy↗