Pediatric Anesthesia Management for Post-Tonsillectomy Bleed: Current Status and Future Directions

Authors

Angela C. Lee, Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Manon Haché, Division of Pediatric Anesthesia, Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA.

Document Type

Journal Article

Publication Date

1-1-2022

Journal

International journal of general medicine

Volume

15

DOI

10.2147/IJGM.S312866

Keywords

anesthetic management; pediatric; post-tonsillectomy hemorrhage; postoperative emergencies

Abstract

After medical stabilization, several techniques are considered for anesthesia in the surgical intervention of post-tonsillectomy bleeding in children. Hypoxia during induction of general anesthesia occurs more frequently than aspiration for this population. While classical (apneic) rapid sequence induction and intubation with cricoid pressure still has a role, controlled rapid sequence induction and intubation that incorporates mask ventilation at low pressure (<12 cm HO) before direct laryngoscopy under a deep plane of anesthesia is a viable alternative for cases of slow venous bleeding. Supplemental oxygen delivery during laryngoscopy to permit apneic oxygenation is a future trend in management. While the routine administration of tranexamic acid during tonsillectomy has not been shown to be of benefit, it may have a role in post-tonsillectomy hemorrhage with further study.

APA Citation

Lee, Angela C. and Haché, Manon, "Pediatric Anesthesia Management for Post-Tonsillectomy Bleed: Current Status and Future Directions" (2022). GW Authored Works. Paper 407.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/407

Department

Anesthesiology and Critical Care Medicine