• Surendran Thavagnanam, Saou Y Cheong, Karuthan Chinna, Anna M Nathan, and Jessie A de Bruyne.
• Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia.
• J Paediatr Child Health. 2018 May 1; 54 (5): 530-534.

AimAdenotonsillectomy is performed in children with recurrent tonsillitis or obstructive sleep apnoea. Children at risk of post-operative respiratory complications are recommended to be monitored in paediatric intensive care unit (PICU). The aim of the study is to review the risk factors for post-operative complications and admissions to PICU.MethodsA review of medical records of children who underwent adenotonsillectomy between January 2011 and December 2014 was performed. Association between demographic variables and post-operative complications were examined using chi-square and Mann-Whitney tests.ResultsA total of 214 children were identified, and of these, 19 (8.8%) experienced post-operative complications. Six children (2.8%) had respiratory complications: hypoxaemia in four and laryngospasm requiring reintubation in a further two. Both of the latter patients were extubated upon arrival to PICU and required no escalation of therapy. A total of 13 (6.1%) children had non-respiratory complications: 8 (3.7%) had infection and 5 (2.3%) had haemorrhage. A total of 26 (12.1%) children were electively admitted to PICU and mean stay was 19.5 (SD ± 13) h. No association between demographic characteristics, comorbid conditions or polysomnographic parameters and post-operative complications were noted. A total of 194 (90.7%) children stayed only one night in hospital (median 1 day, range 1-5 days).ConclusionThe previously identified risk factors and criteria for PICU admission need revision, and new recommendations are necessary.© 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

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