A significant reduction in paediatric post-tonsillectomy vomiting through audit.
BACKGROUND
Postoperative vomiting occurs more frequently after tonsillectomy than any other commonly performed paediatric operation. Postoperative vomiting is also the commonest cause of morbidity and re-admission following tonsillectomy. We present a successful completed audit cycle and literature review on the subject.


METHODS
Data on the risk factors for postoperative vomiting, whether the patient vomited and details of the patient's vomitus were collected prospectively on consecutive patients and compared with a gold standard. Changes in practice were agreed and a second cycle performed.


RESULTS
Two cycles and a total of 107 patients were included in the audit. A significant reduction in vomiting from 27% to 11% was achieved following the introduction of routine use of intravenous dexamethasone during surgery.


CONCLUSIONS
This simple prospective audit of paediatric post-tonsillectomy vomiting has resulted in a statistically significant reduction in vomiting which would appear to be due to use of intra-operative steroids.
Bennett
A M D
AM
ENT Department, Colchester General Hospital, Colchester, UK. a1bennett@hotmail.com
Emery
P J
PJ
D000932:Antiemetics / Q000627:therapeutic use; D002648:Child; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000379:methods*; D017294:Ondansetron / Q000627:therapeutic use; D010347:Patient Care Planning; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D014068:Tonsillectomy / Q000009:adverse effects*
D000932:Antiemetics; D005938:Glucocorticoids; D017294:Ondansetron; D003907:Dexamethasone