International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2013
Reversal of pulmonary hypertension in children after adenoidectomy or adenotonsillectomy.
Adenotonsillar hypertrophy is a common condition in pediatric patients with upper respiratory airways complaints, and pulmonary arterial hypertension (PAH) may be one complication of that condition. ⋯ In children with pulmonary hypertension associated to adenotonsillar hypertrophy, the adenotonsillectomy decreased PAP to normal values in all patients.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2013
ReviewFuture of pediatric tonsillectomy and perioperative outcomes.
Although commonly performed, pediatric tonsillectomy is not necessarily a low risk procedure due to potentially life threatening perioperative complications. There is paucity of literature on lethal anesthesia and surgical complications of tonsillectomy. In this article, we have reviewed both minor and serious complications following tonsillectomy. Hemorrhage, burn injuries, respiratory complications, postoperative nausea and vomiting, and pain management are discussed. We have highlighted our practice of pain management at Cincinnati Children's Hospital after tonsillectomy recent warning about codeine by the FDA on children undergoing tonsillectomy. We describe post-tonsillectomy outcomes including postanesthesia care unit stay, post discharge maladaptive behavioral outcomes and finally effective ways to identify children at risk for anesthesia and a few preventive strategies. ⋯ Tonsillectomy in children carries a high risk of perioperative complications and malpractice claims. Though postoperative bleeding is the most common complication associated with malpractice claims, anoxia related to anesthesia and opioids had the greatest overall risk from a monetary standpoint.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2013
Randomized Controlled TrialRole of topical antibiotic prophylaxis in prevention of bacterial translocation into upper trachea in nasally intubated patients undergoing tonsillectomies.
The human oropharynx and nasopharynx are home of different bacteria and fungi. The initial sterile endotracheal tube (ETT) transfers mechanically the bacteria from the nasopharynx and oropharynx to the sterile tracheobronchial tree. We investigated the efficacy of Neomycin-Bacitracin combination spray in the prevention of this bacterial translocation through its application over and inside the lumen of the endotracheal tubes preoperatively. ⋯ Bacterial translocation by endotracheal intubation to the tracheobronchial tree could be prevented by local antibiotic spray application to outer and inner walls of the endotracheal tubes.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2013
Association of high body mass index in children with early post-tonsillectomy pain.
The purpose of this investigation was to determine whether there is an association between high body mass index (BMI) in children and the occurrence of early post-tonsillectomy pain (PTP). The hypothesis tested was that high BMI is associated with increased severity of early PTP. ⋯ These results indicate that high BMI in children is associated with increased early PTP. The mechanism(s) underlying this association deserve further elucidation.