Perioperative Management of Sickle Cell Disease Children Undergoing Adenotonsillectomy

Objective

To determine if outpatient tailored perioperative management has the same complication rate as that previously published for sickle cell disease (SCD) children who undergo adenotonsillectomy.

Study design and setting

Retrospective chart review of SCD children who underwent tonsillectomy with outcome measures of perioperative management and postsurgical complications.

Results

Of 41 patients, 61% were monitored for <24 hours with the average length of stay being 2 days (range, 1 to 10). Postoperative complications were noted in 9 (22%) patients, including 8 (20%) with hypoxia, 4 (10%) fever, 3 (8%) acute chest syndrome, and 1 (2.4%) airway fire, which are similar to the published literature.

Conclusions

Current literature supports extensive perioperative management with hospital stays averaging 3 to 5 days. These data demonstrate that the majority of these patients can be managed with <24-hour hospitalization stays with similar complication rates as previously described in the literature.

Significance

This study establishes a new paradigm for perioperative management of SCD children who undergo adenotonsillectomy.

EBM rating: C-4