EFFICACY OF GASTRIC ASPIRATION IN REDUCING POST-TONSILLECTOMY VOMITING IN CHILDREN

Authors

  • Raza Muhammad
  • Fazal Wadood
  • Tahir Haroon
  • Zakir Khan
  • Imran Shah

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, Postoperative

References

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.

Published

2012-12-01

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