EFFICACY OF GASTRIC ASPIRATION IN REDUCING POST-TONSILLECTOMY VOMITING IN CHILDREN
Abstract
Background: Nausea and vomiting are two of the most frequently experienced postoperative sideeffects complicating one third of the cases. The objective of this study was to determine theeffectiveness of gastric decompression in reducing the incidence and complications associated withpost-tonsillectomy vomiting in children. Methods: This was a randomised control study conducted atthe ENT Department, Ayub Teaching Hospital Abbottabad from January to June 2012. Patientsincluded in this study were divided into two groups, group A undergoing gastric aspiration and group Bnot undergoing gastric aspiration. Gastric aspiration was done with an oro-gastric tube placed underdirect visualisation while the patient was still under general anaesthesia. The incidence of vomiting,episodes of vomiting and the need for rescue anti-emetic prophylaxis were noted. Results: A total of 54patients were included in the study. Their ages ranged from 5 to12 years with mean age 7.85±2.18years. No statistically significant difference (p>0.05) was noted between the two groups for the patientsexperiencing vomiting (33% vs 41%, p=0.389), the mean number of episodes of vomiting (0.71 vs0.88, p=0.555), and patients requiring rescue anti-emetics (11% vs 15%, p=0.500). Conclusion: Gastricaspiration during tonsillectomy is not useful in reducing post-tonsillectomy vomiting.Keywords: Gastric aspiration, Tonsillectomy, Vomiting, PostoperativeReferences
Windfuhr JP, Schloendorff G, Sesterhenn AM, Prescher
A, Kremer B. A devastating outcome after adenoidectomy and
tonsillectomy: Ideas for improved prevention and management.
Otolaryngol Head Neck Surg 2009:140;191–5.
Aghadavoudi O, Amiri E. Comparison of granisetron,
metoclopramide and gastric decompression for prevention of
postoperative nausea and vomiting after fast track cardiac
anesthesia. J Res Med Sci 2008;13(4):166–74.
Malde AD, Sonawane VS, Jagtap SR. Effect of Dexamethasone
on post tonsillectomy morbidities. Indian J Anesth 2005;49:202–
Al-khotum N, Hiari M, Al-Junndi A, Al-Roosan M, Al-Qudah
A, Shawakfeh N. Comparitive study of orogastric suction and
dexamethasone to reduce vomiting after pediatric tonsillectomy.
J Res Med Sci 2009;16(1):16–21.
Fisher DM. ‘The big little problem” of postoperative nausea and
vomiting: do we know the answer yet? Anesthesiology
;87:1271–3.
Mace L. An audit of post-operative nausea and vomiting,
following cardiac surgery: scope of the problem. Nurs Crit Care
;8(5):187–96.
Jones JE, Tabee A, Glasgold R, Gomillion MC. Efficacay of
gastric aspiration in reducing posttonsillectomy vomiting. Arch
Otolaryngol Head Neck Surg 2001;127:980–4.
Hirsch J. Impact of postoperative nausea and vomiting in the
surgical setting. Anaesthesia 1994;49(suppl):30–3.
Kenny GN. Risk factors for postoperative nausea and vomiting.
Anaesthesia 1994;49(suppl):6–10.
Rose JB, Watcha MF. Postoperative nausea and vomiting in
pediatric patients. Br J Anesth 1999;83:104–17.
Pasternak LR. Anesthetic considerations in otolaryngological and
opthalmological outpatient surgery. Int Anesthesiol Clin
;28(2):89–100.
Kermode J, Wslker S, Webb I. Postoperative vomiting in
children. Anesth Ibtensive Care 1995;23(2):196–9.
Naghibi KH, Hashemi SJ, Montazari K, Nowrozi M,
Comparison of metoclopramide, dexamethasone and their
combination for prevention of postoperative nausea and vomiting
in strabismus surgery. Med J Islamic Acad Sci 2000;13(1):31–3.
Greenspun JC, Hannallah RS, Welborn LG, Norden JM.
Comparison of sevoflurane and halothane anesthesia in children
undergoing outpatient ear, nose and throat surgery. J Clin Anesth
;7:398–402.
Smessaert A, Schehr CA, Artusio JF. Nausea and vomiting in the
immediate postanesthetic period. JAMA 1959;170:2072–6.
Carithers JS, Gebhart DE, Williams JA. Postoperative risks of
pediatric tonsiloadenoidectomy. Laryngoscope 1987;97:422–9.
Pandit UA, Malviya S, Lewis IH. Vomiting after outpatient
tonsillectomy and adenoidectomy in children: the role of nitrous
oxide. Anesth Analg 1995;80:230–3.
Hovorka J, Korttila K, Erkola O. Gastric aspiration at the end of
anesthesia doesnot decrease postoperative nausea and vomiting.
Anaesth Intensive Care 1990;18(1):58–61.
Trepanier CA, Isabel L. Perioperative gastric aspiration increases
postoperative nausea and nomiting in outpatients. Can J Anaesth
;40:325–8.
Dent SJ, Ramachandra V, Stephen CR. Postoperative vomiting:
incidence, analysis and therapeutic measures in 3000 patients.
Anesthesiology 1955;16:564–72.
Holmes CM. Postoperative vomiting after ether/air anaesthesia.
Anaesthesia 1965;20:199–206.
Ferrai LR, Donlon JV. Metochlorpropamide reduces the
incidence of vomiting after tonsillectomy in children. Anesth
Analg 1992;75:351–4.
Furst SR, Rodarte A. Prophylactic antiemetic treatment with
ondansetron in children undergoing tonsillectomy.
Anesthesiology 1994;81:799–803.
Litman RS,Wu CL, Catanzaro FA. Ondansetron decreases enesis
after tonsillectomy in children. Anesth Analg 1994;78:478–81.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.