Abstract
To estimate the average operative blood loss in tonsillectomy and adenotonsillectomy and the various factors affecting it. A prospective study of estimation of blood loss in 100 patients who underwent tonsillectomy and adenotonsillectomy. Data collected included the age, sex, operative indication, clotting time, Hb levels and usage of pre-operative antibiotics. Cold knife dissection method for tonsillectomy and curettage method for adenoidectomy were used. Measurement by calorimetric method of estimation being simple and accurate was used for estimation. Study undertaken at a tertiary referral hospital catering to an urban, semi-urban and rural populace. Blood loss was more in males and increases as age advances both in adenotonsillectomy and tonsillectomy. Blood loss was more in fibrosed tonsils, at lower hemoglobin levels and at higher clotting times. It was less in cases who received pre-operative antibiotics. The average blood losses in males and females during tonsillectomy were 106.91 and 96.26 ml respectively. In adenotonsillectomy, the average blood losses in males and females were 81.44 and 76.82 ml respectively. In our series we found that blood loss in tonsillectomy and adenotonsillectomy depended on various factors like age, sex, the type of tonsillitis, method of dissection, hemoglobin concentration, clotting time and the use of antibiotics. All these factors must be taken into consideration while taking up patients especially those who cannot tolerate blood loss, for surgery.
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References
Blomgren K, Qvarnberg YH, Valtonen HJ (2001) A prospective study on pros and cons of electrodissection tonsillectomy. Laryngoscope 111:478–482
Koempel JA (2002) On the origin of tonsillectomy and the dissection method. Laryngoscope 112:1583–1586
Ruggles RL (1960) Blood loss during adenoidectomy and tonsillectomy measured with radioisotopes. Ann Otol 69:360
Holden HB, Maher JJ (1965) Some aspects of blood loss and fluid balance in paediatric adenotonsillectomy. Br Med J 2:1349–1351
Haq IU, Dundee JW (1968) Studies of drugs given before anaesthesia. XVI: oral diazepam and trimeprazine for adenotonsillectomy. Br J Anaesth 40:972
Shalom AS (1964) Blood loss in ear nose and throat operations. J Laryngol Otol 78:734
Callanan V, Curran AJ, Smyth DA, Gormley PK (1995) The influence of bismuth subgallate and adrenaline paste upon operating time and operative blood loss in tonsillectomy. J Laryngol Otol 109:206–208
Boliston TA, Upton JJ (1980) Infiltration with lignocaine and adrenaline in adult tonsillectomy. J Laryngol Otol 94(11):1257–1259
de Reynier JP (1959) Hemorrhage during tonsillectomy. Pract Otorhinolaryngol 21(1):18–23
Maier HL, Bogue CR (1960) Measurement of blood loss during tonsillectomy and adenoidectomy. Northwest Med 59:910–913
Mann DG, George CST, Scheiner GD, Imber P, Mlynarczyk FA (1984) Tonsillectomy-some like it hot. Laryngoscope 94:677–679
Carithen JS, Gebhart DE, Williams JUA, Columbus OH (1987) Postoperative risks of paediatric tonsilloadenoidectomy. Laryngoscope 97(4):422–429
Broadman LM, Patel RI, Feldman BA, Sellman GL, Milmoe G, Camilon F (1989) The effects of peritonsillar infiltration on the reduction of intraoperative blood loss and post-tonsillectomy pain in children. Laryngoscope 99(6 Pt 1):578–581
Rasgon BM, Cruz RM, Hilsinger RL Jr, Korol HW, Callan E, Wolgat RA, Selby JV (1991) Infiltration of epinephrine in tonsillectomy: a randomized, prospective, double-blind study. Laryngoscope 101(2):114–118
Arora YR, Manford MLM (1979) Operative blood loss and the frequency of hemorrhage associated with adenotonsillectomy in children: a double-blind trial of ethamsylate. Br J Anaesth 51:557–561
Sorensen WT, Henrichsen J, Bonding P (1999) Does bismuth subgallate have haemostatic effects in tonsillectomy? Clin Otolaryngol Allied Sci 24(1):72–74
Trent CS (1993) Electrocautery versus epinephrine-injection tonsillectomy. Ear Nose Throat J 72(8):520–522
Wiatrak BJ, Willging P (2002) Harmonic scalpel for tonsillectomy. Laryngoscope 112:14–16
Kothari P, Patel S, Brown P, Obara L, O’Malley S (2002) A prospective double blind randomized controlled trial comparing the suitability of KTP laser tonsillectomy with conventional dissection tonsillectomy for day case surgery. Clin Otolaryngol Allied Sci 27(5):369–373
Jackel MC, Petzold S, Dimmer V, Mall G, Reck R (2003) Tonsillectomy by CO2 laser microsurgery–an analysis of clinical and morphological data. HNO 51(8):634–639
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Prasad, K.C., Prasad, S.C. Assessment of Operative Blood Loss and the Factors Affecting it in Tonsillectomy and Adenotonsillectomy. Indian J Otolaryngol Head Neck Surg 63, 343–348 (2011). https://doi.org/10.1007/s12070-011-0268-9
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DOI: https://doi.org/10.1007/s12070-011-0268-9