[Hypertrophic tonsils, upper airway obstruction and cardiac complications. A combined otological, medical and anesthesiological problem].
Hypoventilation in children with hypertrophied tonsils can cause hypoxemia, hypercarbia, acidosis and pulmonary vasoconstriction resulting in cardiac arrhythmias or cor pulmonale. In addition, cerebral symptoms such as day-time hypersomnia or even seizures may be present. Early recognition of hypertrophied tonsils is necessary to avoid development of severe cardiac symptoms. If cardiac incompensation is present, medical treatment is advocated prior to tonsillectomy. Anaesthesia for tonsillectomy in these children is associated with special considerations. Preoperative sedation should be excluded, and inhalational induction with O2 and Halothane is recommended. On induction a difficult intubation should be expected.
Feilberg
V L
VL
Hillerød Sygehus, anaestesiafdelingen.
Sørensen
J N
JN
Eriksen
H O
HO
D000768:Anesthesia, General / Q000009:adverse effects; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D006984:Hypertrophy; D007223:Infant; D008173:Lung Diseases, Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008297:Male; D015508:Nasal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014066:Palatine Tonsil / Q000473:pathology*; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013610:Tachycardia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014068:Tonsillectomy
Hypertrofiske tonsiller, øvre luftvejsobstruktion og kardiale komplikationer. Et kombineret otologisk, medicinsk og anoestesiologisk problem.