Short-stay outpatient tonsillectomy.
OBJECTIVE
To determine the risk of complications after discharge in outpatient adenotonsillectomy after a short (< 6 hours) period of postoperative observation.


METHODS
Retrospective chart review.


METHODS
Outpatient surgery center at a university hospital.


METHODS
All patients 18 years of age or less who were scheduled for adenotonsillectomy or tonsillectomy from January 1988 through December 1991. Two hundred fifty-five patient records were reviewed. Twenty-two patients were excluded from the study because of various complicating medical conditions that required planned overnight hospitalization leaving a study population of 233 patients.


METHODS
(1) Rate and type of complications; (2) duration of postoperative observation.


RESULTS
Complication rates of bleeding, emesis, dehydration, and readmission were compared with rates deemed acceptable in the literature (< or = 10%). Power analysis demonstrated that the patient number was sufficient to establish a 95% confidence interval for a complication rate of 0% to 10%. The mean duration of postoperative observation was 136 +/- 48 minutes. Complications included bleeding, emesis, dehydration, and nonscheduled admissions. The total complication rate was 9% (95% confidence interval, 5.5% to 12.7%). The rate of primary bleeding was 1.4%, and all primary bleeding occurred within 75 minutes of arrival in the recovery room; no primary bleeding occurred after discharge from day surgery. This complication rate is comparable with rates previously described in the literature for patients who were observed for a 6- to 12-hour period.


CONCLUSIONS
The findings in this study suggest that short periods of observation are safe for outpatient pediatric patients undergoing adenotonsillectomy after discharge criteria are met.
Nicklaus
P J
PJ
Division of Otolaryngology, University of New Mexico, Albuquerque, USA.
Herzon
F S
FS
Steinle
E W
EW
D000233:Adenoidectomy / Q000379:methods / Q000706:statistics & numerical data; D000293:Adolescent; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009516:New Mexico / Q000453:epidemiology; D006472:Oral Hemorrhage / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014068:Tonsillectomy / Q000379:methods / Q000706:statistics & numerical data