The impact of different types of anaesthesia on the course of tonsillectomy surgery
DOI:
https://doi.org/10.12775/JEHS.2023.13.04.048Keywords
recurrent tonsillitis, tonsillectomy, bleeding, tranexamic acid, local anaesthesia, endotracheal anaesthesiaAbstract
Recurrent tonsillitis is considered to be one of the most common ENT diseases. Tonsillectomy as a method of recurrent tonsillitis' treatment is being performed as usual as 20% of all surgeries in ENT departments. The critical criteria for the success of tonsillectomy for the surgeon are the frequency of perioperative complications, long-term results of treatment, and the patient's recovery time. For the patient, those criteria are the severity of pain, psychoemotional stress, the time spent in the hospital, and how quickly he can return to his daily life routine. The factors that significantly affect the outcome of tonsillectomy are the choice of anaesthetic management.
Our study aimed to optimise the approach to choosing between endotracheal anaesthesia and local anaesthesia. Clinical studies were made among 158 patients with recurrent tonsillitis who underwent a bilateral tonsillectomy. The patients were divided into two groups.
The first group consisted of 97 patients undergoing tonsillectomy using local anaesthesia. The control group included 61 patients undergoing tonsillectomy using endotracheal anaesthesia. We considered the factors such as duration of surgery, the amount of blood loss, intraoperative events, number of incidents of primary and secondary bleeding, assessment of pain syndrome, necessity of analgesics administration, length of hospital stay, and recovery period.
Conclusions: tonsillectomy surgery using local anaesthesia requires less time to perform, has less blood loss, fewer intraoperative events, and fewer incidents of primary and secondary bleeding. The average level of pain is higher in patients using endotracheal anaesthesia.
References
Bredenkamp JK, Abemayor E, Wackym PA, Ward PH. Tonsillectomy under local anesthesia: a safe and effective alternative. Am J Otolaryngol. 1990 Jan-Feb;11(1):18-22. doi: 10.1016/0196-0709(90)90165-r. PMID: 2108585
Galindo Torres BP, De Miguel Garcia F, Whyte Orozco J. Tonsillectomy in adults: analysis of indications and complications. Auris Nasus Larynx. 2018;45:517‐521. - PubMed
George A, Kumar R, Kumar S, Shetty S. A randomized control trial to verify the efficacy of pre-operative intra venous tranexamic Acid in the control of tonsillectomy bleeding. Indian J Otolaryngol Head Neck Surg. 2011 Jan;63(1):20-6. doi: 10.1007/s12070-010-0095-4. Epub 2011 Jan 11. PMID: 22319712; PMCID: PMC3109971.
Hopkins C., Geyer M., Topham J. Post-tonsillectomy haemorrhage: A 7-year retrospective study. Eur. Arch. Oto-Rhino-Laryngol. 2003;260:454–455. doi: 10.1007/s00405-003-0609-8.
Juul ML, Rasmussen ER, Rasmussen SHR, Sørensen CH, Howitz MF. A nationwide registry-based cohort study of incidence of tonsillectomy in Denmark, 1991-2012. Clin Otolaryngol. 2018 Feb;43(1):274-284. doi: 10.1111/coa.12959. Epub 2017 Sep 13. PMID: 28851039.
Kennedy KS, Strom CG. A comparison of postoperative bleeding incidence between general and local anesthesia tonsillectomies. Otolaryngol Head Neck Surg. 1990 Jun;102(6):654-7. doi: 10.1177/019459989010200605. PMID: 2115650
Marioni G., Filippis C., Tregnaghi A., Gaio E, Staffieri A. Cervical emphysema and pneumomediastinum after tonsillectomy: It can happen // Otolaryngol Head Neck Surg. 2003. Vol. 128. Р. 298–300. Doi:)
Matovinović F, Bacan F, Kereković E, Pegan A, Rašić I, Košec A. Risks and benefits of local anesthesia versus general anesthesia in tonsillectomy. Am J Otolaryngol. 2018 Sep-Oct;39(5):515-517. doi: 10.1016/j.amjoto.2018.05.015. Epub 2018 May 26. PMID: 29859638.
Sudhir M Naik, Sarika S Naik, S Ravishankara, Mohan K Appaji, MK Goutham, Nonthombam Pinky Devi, Annapurna S Mushannavar Advantages of Tonsillectomy done under Local Anesthesia compared to General Anesthesia in AdultsVolume:4, issue:1(2013) International Journal of Head and Neck Surgery
Tisch M, Bruder M, Maier H: Risk of postoperative hemorrhage in tonsillectomy. A comparison between general anesthesia and local anesthesia (in German). HNO 2002;50:230-232.
Windfuhr JP. Tonsillektomie: offizielle Zahlen und Trends in Deutschland [Tonsil Surgery in Germany: Rates, Numbers and Trends]. Laryngorhinootologie. 2016 Apr;95 Suppl 1:S88-S109. German. doi: 10.1055/s-0041-109594. Epub 2016 Apr 29. PMID: 27128406.
Young J. R., Bennett J. History of tonsillectomy //ENT News. – 2004. – Т. 13. – С. 34-35.
Popovich, V. I. (2014). Chronic Tonsillitis and Associated Somatic Diseases. Natural Medicine, 1, 74-82.
Tyshko, F. O., Hychka, S. G., Stas, V. G., et al. (2015). Choice of Treatment Method for Patients with Chronic Tonsillitis. In XII Congress of Otorhinolaryngologists of Ukraine (Lviv, May 18-20, 2015) (pp. 142-143). Lviv.
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