Discharge after tonsillectomy in pediatric sleep apnea patients

Regina Rodman, Mitchell Boehnke, Naren Venkatesan, Harold Pine

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: Outpatient tonsillectomy has gained favor in recent years, however patients with obstructive sleep apnea/hypopnea syndrome have been excluded from outpatient surgery criteria. It is the practice of the senior author to discharge patients after tonsillectomy with a respiratory disturbance or apnea hypopnea index of 5 or less. The purpose of this study is to examine the respiratory complication rate based on respiratory disturbance or apnea hypopnea index, and co-morbidities in order to determine which pediatric patients with obstructive sleep apnea/hypopnea syndrome can be safely discharged after tonsillectomy. Methods: All patients undergoing tonsillectomy with the diagnosis of obstructive sleep apnea made by polysomnography by a single surgeon from 2008 to 2011 were included. Decision to admit was based on respiratory disturbance or apnea hypopnea index, body mass index, and comorbidities. All inpatient notes, phone calls, and follow up visit documentation were monitored and reviewed for post operative complications. Results: 104 patients were included, 74 patients were admitted post operatively, and 30 were discharged home. There were no complications in the group that was discharged home. In the group that was admitted, there was two minor and two intermediate complications, including desaturations to 92% and 83% requiring oxygen, and wheezing requiring breathing treatment. All complications occurred in patients with respiratory disturbance or apnea hypopnea index of 11 or greater. Conclusion: Our data suggest there is a correlation between higher respiratory disturbance or apnea hypopnea index and post operative complications. Patients with an RDI of <5.0, and minimal co-morbidities can be safely discharged home following tonsillectomy for OSAHS. Complications related to sleep apnea were not seen in patients with RDI <11.0, suggesting that patients with an RDI between 5 and 10, who are not obese and have no significant comorbidities may also be sent home after surgery.

Original languageEnglish (US)
Pages (from-to)682-685
Number of pages4
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume77
Issue number5
DOIs
StatePublished - May 2013

Fingerprint

Tonsillectomy
Sleep Apnea Syndromes
Obstructive Sleep Apnea
Pediatrics
Apnea
Comorbidity
Morbidity
Polysomnography
Patient Discharge
Respiratory Sounds
Respiratory Rate
Ambulatory Surgical Procedures
Documentation
Inpatients
Respiration
Body Mass Index
Outpatients
Oxygen

Keywords

  • Hypoxia
  • Obstructive sleep apnea
  • Outpatient
  • Polysomnography
  • Post operative complications
  • Tonsillectomy

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health

Cite this

Discharge after tonsillectomy in pediatric sleep apnea patients. / Rodman, Regina; Boehnke, Mitchell; Venkatesan, Naren; Pine, Harold.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 77, No. 5, 05.2013, p. 682-685.

Research output: Contribution to journalArticle

Rodman, Regina ; Boehnke, Mitchell ; Venkatesan, Naren ; Pine, Harold. / Discharge after tonsillectomy in pediatric sleep apnea patients. In: International Journal of Pediatric Otorhinolaryngology. 2013 ; Vol. 77, No. 5. pp. 682-685.
@article{80e93eae023e461088150f818bbf81df,
title = "Discharge after tonsillectomy in pediatric sleep apnea patients",
abstract = "Objectives: Outpatient tonsillectomy has gained favor in recent years, however patients with obstructive sleep apnea/hypopnea syndrome have been excluded from outpatient surgery criteria. It is the practice of the senior author to discharge patients after tonsillectomy with a respiratory disturbance or apnea hypopnea index of 5 or less. The purpose of this study is to examine the respiratory complication rate based on respiratory disturbance or apnea hypopnea index, and co-morbidities in order to determine which pediatric patients with obstructive sleep apnea/hypopnea syndrome can be safely discharged after tonsillectomy. Methods: All patients undergoing tonsillectomy with the diagnosis of obstructive sleep apnea made by polysomnography by a single surgeon from 2008 to 2011 were included. Decision to admit was based on respiratory disturbance or apnea hypopnea index, body mass index, and comorbidities. All inpatient notes, phone calls, and follow up visit documentation were monitored and reviewed for post operative complications. Results: 104 patients were included, 74 patients were admitted post operatively, and 30 were discharged home. There were no complications in the group that was discharged home. In the group that was admitted, there was two minor and two intermediate complications, including desaturations to 92{\%} and 83{\%} requiring oxygen, and wheezing requiring breathing treatment. All complications occurred in patients with respiratory disturbance or apnea hypopnea index of 11 or greater. Conclusion: Our data suggest there is a correlation between higher respiratory disturbance or apnea hypopnea index and post operative complications. Patients with an RDI of <5.0, and minimal co-morbidities can be safely discharged home following tonsillectomy for OSAHS. Complications related to sleep apnea were not seen in patients with RDI <11.0, suggesting that patients with an RDI between 5 and 10, who are not obese and have no significant comorbidities may also be sent home after surgery.",
keywords = "Hypoxia, Obstructive sleep apnea, Outpatient, Polysomnography, Post operative complications, Tonsillectomy",
author = "Regina Rodman and Mitchell Boehnke and Naren Venkatesan and Harold Pine",
year = "2013",
month = "5",
doi = "10.1016/j.ijporl.2013.01.013",
language = "English (US)",
volume = "77",
pages = "682--685",
journal = "International Journal of Pediatric Otorhinolaryngology",
issn = "0165-5876",
publisher = "Elsevier Ireland Ltd",
number = "5",

}

TY - JOUR

T1 - Discharge after tonsillectomy in pediatric sleep apnea patients

AU - Rodman, Regina

AU - Boehnke, Mitchell

AU - Venkatesan, Naren

AU - Pine, Harold

PY - 2013/5

Y1 - 2013/5

N2 - Objectives: Outpatient tonsillectomy has gained favor in recent years, however patients with obstructive sleep apnea/hypopnea syndrome have been excluded from outpatient surgery criteria. It is the practice of the senior author to discharge patients after tonsillectomy with a respiratory disturbance or apnea hypopnea index of 5 or less. The purpose of this study is to examine the respiratory complication rate based on respiratory disturbance or apnea hypopnea index, and co-morbidities in order to determine which pediatric patients with obstructive sleep apnea/hypopnea syndrome can be safely discharged after tonsillectomy. Methods: All patients undergoing tonsillectomy with the diagnosis of obstructive sleep apnea made by polysomnography by a single surgeon from 2008 to 2011 were included. Decision to admit was based on respiratory disturbance or apnea hypopnea index, body mass index, and comorbidities. All inpatient notes, phone calls, and follow up visit documentation were monitored and reviewed for post operative complications. Results: 104 patients were included, 74 patients were admitted post operatively, and 30 were discharged home. There were no complications in the group that was discharged home. In the group that was admitted, there was two minor and two intermediate complications, including desaturations to 92% and 83% requiring oxygen, and wheezing requiring breathing treatment. All complications occurred in patients with respiratory disturbance or apnea hypopnea index of 11 or greater. Conclusion: Our data suggest there is a correlation between higher respiratory disturbance or apnea hypopnea index and post operative complications. Patients with an RDI of <5.0, and minimal co-morbidities can be safely discharged home following tonsillectomy for OSAHS. Complications related to sleep apnea were not seen in patients with RDI <11.0, suggesting that patients with an RDI between 5 and 10, who are not obese and have no significant comorbidities may also be sent home after surgery.

AB - Objectives: Outpatient tonsillectomy has gained favor in recent years, however patients with obstructive sleep apnea/hypopnea syndrome have been excluded from outpatient surgery criteria. It is the practice of the senior author to discharge patients after tonsillectomy with a respiratory disturbance or apnea hypopnea index of 5 or less. The purpose of this study is to examine the respiratory complication rate based on respiratory disturbance or apnea hypopnea index, and co-morbidities in order to determine which pediatric patients with obstructive sleep apnea/hypopnea syndrome can be safely discharged after tonsillectomy. Methods: All patients undergoing tonsillectomy with the diagnosis of obstructive sleep apnea made by polysomnography by a single surgeon from 2008 to 2011 were included. Decision to admit was based on respiratory disturbance or apnea hypopnea index, body mass index, and comorbidities. All inpatient notes, phone calls, and follow up visit documentation were monitored and reviewed for post operative complications. Results: 104 patients were included, 74 patients were admitted post operatively, and 30 were discharged home. There were no complications in the group that was discharged home. In the group that was admitted, there was two minor and two intermediate complications, including desaturations to 92% and 83% requiring oxygen, and wheezing requiring breathing treatment. All complications occurred in patients with respiratory disturbance or apnea hypopnea index of 11 or greater. Conclusion: Our data suggest there is a correlation between higher respiratory disturbance or apnea hypopnea index and post operative complications. Patients with an RDI of <5.0, and minimal co-morbidities can be safely discharged home following tonsillectomy for OSAHS. Complications related to sleep apnea were not seen in patients with RDI <11.0, suggesting that patients with an RDI between 5 and 10, who are not obese and have no significant comorbidities may also be sent home after surgery.

KW - Hypoxia

KW - Obstructive sleep apnea

KW - Outpatient

KW - Polysomnography

KW - Post operative complications

KW - Tonsillectomy

UR - http://www.scopus.com/inward/record.url?scp=84876707775&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876707775&partnerID=8YFLogxK

U2 - 10.1016/j.ijporl.2013.01.013

DO - 10.1016/j.ijporl.2013.01.013

M3 - Article

VL - 77

SP - 682

EP - 685

JO - International Journal of Pediatric Otorhinolaryngology

JF - International Journal of Pediatric Otorhinolaryngology

SN - 0165-5876

IS - 5

ER -