Tonsillectomy, Adenoidectomy, and Myringotomy in Sickle Cell Disease
- 1 March 1999
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Pediatric Hematology/Oncology
- Vol. 21 (2), 129-135
- https://doi.org/10.1097/00043426-199903000-00009
Abstract
To compare the rates of perioperative morbidity of patients with sickle cell anemia who were randomly assigned to 2 preoperative transfusion regimens and to identify predisposing factors for perioperative complications. Investigators at 36 centers enrolled 118 patients who were scheduled to have elective surgery and agreed to randomization between 2 preoperative transfusion regimens. Forty-seven subjects were enrolled but not randomized, including 20 who were not transfused before surgery. Perioperative management was based on a prescribed care plan. Tonsillectomy and/or adenoidectomy (TA) were performed on 136 persons, and 29 had myringotomy as their primary procedure. There were no differences in the frequency of complications between the randomized groups. The serious, non-transfusion complication rates for randomized patients were 32% (34 of 107) for TA and 36% (4 of 11) for myringotomy. A history of pulmonary disease was a predictor of postoperative sickle cell-related events for patients undergoing TA surgery. The more intensive transfusion regimen did not result in fewer perioperative complications. The high frequency of complications emphasizes the need for anticipatory management of persons undergoing TA. A history of pulmonary disease identifies patients at increased risk for sickle cell-related events after TA surgery. Patients undergoing myringotomy have a low frequency of sickle cell-related events but a significant frequency of other serious perioperative complications.Keywords
This publication has 31 references indexed in Scilit:
- Perioperative ketorolac tromethamine and postoperative hemorrhage in cases of tonsillectomy and adenoidectomyThe Laryngoscope, 1995
- Elective surgery in children with sickle cell disease without preoperative blood transfusionJournal of Pediatric Surgery, 1993
- Preoperative transfusion in sickle cell anemiaAmerican Journal of Hematology, 1991
- Safe surgery in sickle cell diseaseBritish Journal of Surgery, 1991
- Adenotonsillectomy in Children With Sickle Cell DiseaseSouthern Medical Journal, 1991
- Sickle cell states and the anaesthetistCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 1988
- Assessment of the Use of Transfusion Therapy Perioperatively in Patients with Sickle Cell HemoglobinopathiesAnnals of Surgery, 1988
- Myringotomy and ventilation tubes: A report of 1,568 earsThe Laryngoscope, 1982
- Preoperative exchange transfusion in sickle cell anemiaJournal of Pediatric Surgery, 1981
- General anaesthesia in sickle-cell disease.BMJ, 1979