Sleep studies may assist in predicting respiratory complications after tonsil surgery

Jaryszak EM. Arch Otolaryngol Head Neck Surg. 2011;137:15-18.

Performing a sleep study before pediatric adenotonsillectomy may help identify children at a higher risk for developing postoperative respiratory complications, according to a study.

Guidelines for adenotonsillectomy, established by the American Academy of Otolaryngology-Head and Neck Surgery, recommend that children should be healthy, older than 3 years and have no evidence of obstructive sleep apnea-hypopnea syndrome before surgery.

To determine if a sleep study may potentially predict adverse outcomes after a pediatric adenotonsillectomy, Eric M. Jaryszak, MD, and colleagues from the George Washington University School of Medicine retrospectively examined the records of 1,131 children who underwent an adenotonsillectomy by two attending surgeons at an academic pediatric hospital.

The researchers said sleep studies were performed on 151 patients, or 13.4% of all the patients who had the procedure. Of these, 23 patients experienced adverse respiratory events after surgery. These patients typically had higher apnea-hypopnea index, higher hypopnea index and lower nadir oxygen saturation noted in their sleep studies.

Additionally, the 23 patients who experienced complications had a higher BMI compared with those who did not have complications.

Overall, the patients who experienced adverse respiratory events spent an additional 22 days in the hospital beyond routine overnight observation for those with obstructive sleep apnea-hypopnea syndrome.

“Polysomnographic data may potentially be used for predicting which patients are at higher risk for adverse respiratory events after adenotonsillectomy,” the researchers concluded. “Such knowledge is valuable in planning postoperative management and perhaps intraoperative anesthesia management.”

Disclosure: The researchers reported no relevant disclosures.

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