What are the common postanesthesia care unit problems anticipated following adenotonsillectomy?
Postanesthesia care unit problems specific to adenoton-sillectomy are hemorrhage and airway obstruction. Oozing or frank hemorrhage into the airway may occur. Blood from adenotonsillar beds is usually swallowed. Consequently, blood loss is not measurable, and significant hemorrhage may remain undiagnosed. Tachycardia, diaphoresis, ortho-static hypotension, pallor, and hematemesis may be the presenting signs of postoperative hemorrhage. Often only small amounts of blood are seen on bed sheets.
Airway obstruction may result from many etiologies. During emergence from anesthesia, lax oropharyngeal tissues can prolapse into the airway, creating obstruction. Surgical edema and hematomas exacerbate the process.
Many drug regimens have been advocated to reduce postoperative nausea and vomiting. Dexamethasone and ondansetron have an excellent track record if given pro-phylactically for this specific type of surgery.