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.
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