Luciana Pimentel Oppermann1, José Faibes Lubianca Neto2, Renata Loss Drummond3, Sérgio Luis Amantéa4, Mariele Bressan5, Eduardo Esteves de Alcântara Marques Rodrigues6, Maira Isis Dos Santos Stangler7. 1. Department of Pediatric Otolaryngology of Hospital da Criança Santo Antônio/Postgraduate Program in Pediatrics, Irmandade da Santa Casa de Misericórdia de Porto Alegre/Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. luopp24@hotmail.com. 2. Department of Pediatric Otolaryngology of Hospital da Criança Santo Antônio/Postgraduate Program in Pediatrics, Irmandade da Santa Casa de Misericórdia de Porto Alegre/Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. 3. Department of Pediatric Otolaryngology of Hospital da Criança Santo Antônio, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil. 4. Department of Pediatrics of Hospital da Criança Santo Antônio/Postgraduate Program in Pediatrics, Irmandade da Santa Casa de Misericórdia de Porto Alegre/Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. 5. Department of Otolaryngology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. 6. Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. 7. Department of Corporate Education in Nursing of Hospital da Criança Santo Antônio/Postgraduate Program in Pediatrics, Irmandade da Santa Casa de Misericórdia de Porto Alegre/Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
Abstract
PURPOSE:Nausea and vomiting occur in up to 70% of children after adenotonsillectomy, ingested blood during procedure being one of the reasons for emesis. Hypopharyngeal packing (HP) is a common practice among otolaryngologists to prevent blood from being swallowed, but studies in nasal surgeries in adults failed to show efficacy of this technique in reducing postoperative nausea and vomiting (PONV). There are no studies evaluating the effect of HP in adenotonsillectomy in children. The aim of this study is to evaluate the efficacy HP during adenotonsillectomy in children in the prevention of PONV. METHODS: This is a randomized, double-blinded, controlled trial. Children aged 4-16 years, scheduled for adenotonsillectomy due to sleep-disordered breathing were enrolled in Hospital da Criança Santo Antônio (Brazil). 192 participants were screened, while 129 were enrolled and completed follow-up for primary outcome. Patients were randomized in a consecutive manner to receive HP or not during adenotonsillectomy. PONV occurrence was assessed in the first 24 h after surgery in HP and control group and relative risk with 95% confidence interval was calculated. RESULTS: There were 129 patients randomized, 64 in the HP and 65 in the control group. Female were 40.3% and mean ± SD age was 7.3 ± 2.9. Baseline characteristics and surgery variables were distributed similarly between the groups. Incidence of PONV was 20.3% in the HP and 23.1% in the control group. The relative risk for PONV was 0.88 (95% CI 0.46-1.70). CONCLUSION: Our results suggest that there is no benefit of HP during adenotonsillectomy in children for the prevention of PONV. TRIAL REGISTRATION: Brazilian Register of Randomized Trials (REBEC) identifier: RBR-3zjn27; Universal Trial Number U1111-1197-7461.
RCT Entities:
PURPOSE:Nausea and vomiting occur in up to 70% of children after adenotonsillectomy, ingested blood during procedure being one of the reasons for emesis. Hypopharyngeal packing (HP) is a common practice among otolaryngologists to prevent blood from being swallowed, but studies in nasal surgeries in adults failed to show efficacy of this technique in reducing postoperative nausea and vomiting (PONV). There are no studies evaluating the effect of HP in adenotonsillectomy in children. The aim of this study is to evaluate the efficacy HP during adenotonsillectomy in children in the prevention of PONV. METHODS: This is a randomized, double-blinded, controlled trial. Children aged 4-16 years, scheduled for adenotonsillectomy due to sleep-disordered breathing were enrolled in Hospital da Criança Santo Antônio (Brazil). 192 participants were screened, while 129 were enrolled and completed follow-up for primary outcome. Patients were randomized in a consecutive manner to receive HP or not during adenotonsillectomy. PONV occurrence was assessed in the first 24 h after surgery in HP and control group and relative risk with 95% confidence interval was calculated. RESULTS: There were 129 patients randomized, 64 in the HP and 65 in the control group. Female were 40.3% and mean ± SD age was 7.3 ± 2.9. Baseline characteristics and surgery variables were distributed similarly between the groups. Incidence of PONV was 20.3% in the HP and 23.1% in the control group. The relative risk for PONV was 0.88 (95% CI 0.46-1.70). CONCLUSION: Our results suggest that there is no benefit of HP during adenotonsillectomy in children for the prevention of PONV. TRIAL REGISTRATION: Brazilian Register of Randomized Trials (REBEC) identifier: RBR-3zjn27; Universal Trial Number U1111-1197-7461.
Entities:
Keywords:
Children; Postoperative nausea and vomiting; Surgical gauze packing; Tonsillectomy
Authors: S A Ved; T L Walden; J Montana; D E Lea; M C Tefft; B K Kataria; M A Pudimat; H F Nicodemus; G J Milmoe Journal: Anesthesiology Date: 1996-07 Impact factor: 7.892