title: Post-operative nausea and vomiting following paediatric day-case tonsillectomy: audit of the Epsom protocol.
abstract: OBJECTIVE
  To audit a protocol for elective, day-case, paediatric ENT surgery, previously reported as enabling an overall post-operative nausea and vomiting rate of 2 per cent and a discharge rate of 100 per cent on the day of surgery.
  
  
  METHODS
  The audit included 91 children (45 boys and 46 girls) aged three to 14 years. Forty-seven children underwent tonsillectomy, 36 adenotonsillectomy and eight tonsillectomy with postnasal space examination; indications included recurrent tonsillitis, tonsillitis and nasal block, upper airway obstruction, and a combination of upper airway obstruction and recurrent tonsillitis.
  
  
  RESULTS
  No post-operative nausea or vomiting was recorded in any of the children on the day of surgery, and no discharges were delayed. The reactionary haemorrhage rate was 1 per cent and the secondary haemorrhage rate 3.3 per cent.
  
  
  CONCLUSIONS
  These findings have implications for the safe same-day discharge of children following tonsillectomy.
authors.affiliation: Department of Otolaryngology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Robb
authors.forename: B N
authors.initials: BN
authors.lastname: Ewah
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects / Q000379:methods; D000293:Adolescent; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D000768:Anesthesia, General / Q000379:methods*; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D017294:Ondansetron / Q000008:administration & dosage / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy; D010351:Patient Discharge; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000209:etiology* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*; D014839:Vomiting / Q000209:etiology / Q000517:prevention & control
chemical_list: D000700:Analgesics; D000932:Antiemetics; D017294:Ondansetron; D003907:Dexamethasone