title: Pediatric Adenotonsillectomy in a Low Resource Setting: Lessons and Implications.
abstract: OBJECTIVE
  To examine the practices related paediatric adenotonsillectomy in our setting especially in relation to blood request and transfusion, routine investigations, post-operative analgesic practice and complications.
  
  
  METHODS
  We reviewed the record of paediatric patients who had adenotonsillectomy in our facility over a 5-year period to obtain relevant information to our study.
  
  
  RESULTS
  There were 33 males and 19 females with mean age of 3.27 ± 2.76 years. Sinus tachycardia was found in 11(21.2 %) of the subjects and T wave anomaly in 1(1.9%) of the subject. Thirty-five (67.3%) patient had adenotonsillectomy, 13(25.0 %) adenoidectomy only and 4(7.7%) tonsillectomy only. Majority of the patients (24, 46.2%) were classified as ASA physical status I. Pre-operative blood request rate was high (49, 94.3%) though the transfusion rate was 1.9 % (1 patient). Acetaminophen combined with other analgesics was used for post-operative analgesia for most of the patients. There was significant weight gain post-operatively among patient.
  
  
  CONCLUSIONS
  Cold steel adenotonsillectomy is safe and effective in our environment. We believe that there is no justification for routine pre-operative blood request as a preconditions for surgery. We also like to suggest that post-operative pain management be streamlined taking into consideration the available analgesics in our setting.
authors.affiliation: Department of Surgery, Otorhinolaryngology Unit, Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Sanyaolu Alani
authors.initials: SA
authors.lastname: Ameye
authors.affiliation: Department of Anaesthesia and Intensive Care, Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Afolabi Muyiwa
authors.initials: AM
authors.lastname: Owojuyigbe
authors.affiliation: Department of Surgery, Otorhinolaryngology Unit, Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Adekunle
authors.initials: A
authors.lastname: Adeyemo
authors.affiliation: Department of Anaesthesia and Intensive Care, Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Adenekan
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Ouche
keywords: Adenoidectomy; analgesia; pediatric; tonsillectomy; transfusion