Objective: to determine whether intraoperative dexamethasone is a risk factor for secondary posttonsillectomy bleeding.
Design: retrospective chart review.
Setting: tertiary care referral centres in Scotland.
Method And Patients: the charts of 530 pediatric patients undergoing tonsillectomy were reviewed over a 3-year period (January 2004 to December 2006), and data were collected regarding the use of dexamethasone intraoperatively. Data were analyzed using the SPSS for Windows statistical package (SPSS Inc, Chicago, IL).
Main Outcome Measures: incidence of secondary posttonsillectomy bleeding. The relative risk of posttonsillectomy bleeding was measured in those receiving dexamethasone. Logistic regression analysis was performed.
Results: Thirty-seven episodes of secondary hemorrhage were encountered in 36 children: 9 of 253 (3.6%; 95% CI 1.6-6.7) patients receiving intraoperative dexamethasone compared to 28 of 277 (10.1%; 95% CI 6.8-14.3) not receiving dexamethasone. Six patients had to undergo an emergency reoperation to arrest bleeding, only one of whom had received dexamethasone. When added to a stepwise logistic regression model with age, gender, indication for surgery, surgeon grade, and operative technique, dexamethasone and the presence of obstructive symptoms were the only significant factors influencing the risk of bleeding. The odds ratio indicates that patients with obstructive symptoms (OR 0.16; 95% CI 0.04-0.70) and those receiving dexamethasone were less likely to develop secondary bleeding (OR 0.44; 95% CI 0.20-0.96).
Conclusion: based on our study data, the use of intraoperative dexamethasone does not appear to increase the risk of posttonsillectomy bleeding.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Intraoperative OCT-Guided Selective Epiretinal Membrane (ERM) Peeling Versus ERM and Internal Limiting Membrane Peeling for Tractional Macular Edema in Diabetic Eyes.
Diagnostics (Basel)
November 2024
Department of Ophthalmology, Policlinico Riuniti Foggia, University of Foggia, 71122 Foggia, Italy.
Background And Aim: Despite the abundant literature, internal limiting membrane (ILM) peeling remains a controversial topic, especially in diabetic eyes. We compared the safety and effectiveness of intraoperative optical coherence tomography (iOCT)-assisted selective epiretinal membrane (ERM) peeling with dye-assisted ERM and ILM peeling, for the treatment of tractional diabetic macular edema (tDME).
Material And Methods: In this single-center retrospective study, we evaluated consecutive patients with tDME who underwent iOCT-assisted selective ERM peeling (Group A) or "dual blue" dye-assisted ERM and ILM peeling (Group B).
Back to the Future: Historic Insights and Recent Innovations in Pediatric Regional Anesthesia.
J Clin Med
November 2024
Department of Anesthesiology, Stony Brook University Health Science Center, Stony Brook, NY 11794, USA.
Pediatric regional anesthesia is evolving with new peripheral nerve blocks and techniques aimed at improving perioperative pain management. While caudal blocks have long been standard due to their simplicity and low complication rates, newer fascial plane blocks offer comparable efficacy with enhanced nerve coverage tailored to specific surgeries. Moreover, adjuncts like dexmedetomidine and dexamethasone have shown promise in prolonging block duration and enhancing post-operative pain relief and patient satisfaction.
View Article and Find Full Text PDFIntroduction: We aimed to evaluate the relationship between preexisting chronic pain and acute postoperative pain after laparoscopic cholecystectomy (LC) and to identify predictors of acute postsurgery pain.
Methods: In this prospective cohort study, patients undergoing LC with general anesthesia were enrolled. The primary outcome was the incidence of moderate-to-severe pain during movement in the first 24 hours after surgery.
Successful cutaneous sensory blockade following single-injection and double-injection techniques of ultrasound-guided superficial parasternal intercostal plane block: a randomized clinical trial.
Reg Anesth Pain Med
November 2024
Surgery, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand.
Background: While superficial parasternal intercostal plane blocks can improve analgesia after cardiac surgery, the optimal site and the number of injections remain uncertain. This study aimed to compare the efficacy of single versus double injections of superficial parasternal blocks, hypothesizing that double injections would achieve superior cutaneous sensory blockade.
Methods: 70 cardiac patients undergoing median sternotomy were randomly assigned to receive either single or double injections of superficial parasternal blocks bilaterally.
Variations in Current Practice and Protocols of Intraoperative Multimodal Analgesia: A Cross-Sectional Study Within a Six-Hospital US Health Care System.
Anesth Analg
October 2024
Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California.
Article Synopsis
- The study investigates changes in multimodal analgesia (MMA) practices in postoperative pain management, emphasizing its role in reducing opioid use amid the ongoing opioid crisis.
- Analyzing data from 25,386 surgical procedures at six hospitals between 2017 and 2022, the research found that 46.9% of cases employed MMA, with usage increasing by an average of 3.0% per year.
- Significant variations in MMA application were observed across different hospitals and anesthesiologists, pointing to disparities influenced by patient characteristics and procedural complexities.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!