The Prevalence of Postoperative Respiratory Complications in Paediatric Patients Undergoing Elective Adenotonsillar Surgery at the Kenyatta National Hospital Ear Nose and Throat Satellite Theatre

Abstract

Background Adenotonsillar surgery is one of the most common surgeries performed in the paediatric age group which is between birth and 16 years. It is associated with postoperative respiratory complications. The true picture of the problem in our centre has not been captured. Studies from other parts of the world have put the prevalence of postoperative respiratory complications following adenotonsillar surgery at between 1 and 27%.(1) (2) I carried out a cross-sectional observational study on relatively healthy paediatric patients assigned ASA I and II classification presenting for adenotonsillar surgery to determine the prevalence of postoperative respiratory complications following adenotonsillar surgery in our centre KNH. Broad objective The study aimed at determining the prevalence of postoperative respiratory complications in paediatric patients undergoing adenotonsillar surgery at KNH Ear Nose and Throat ENT satellite theatre. Study Design and Site It was a crossectional observational study conducted on paediatric patients scheduled for elective adenotonsillar surgery in the ENT satellite theatre at KNH. Materials and Methods A total of 109 paediatric patients were recruited a day before surgery from KNH ward 5C. Information on presence of known risk factors associated with respiratory complications in the perioperative period were collected together with anthropometric measurements and entered into a data collection tool. On the day of surgery information on preoperative vitals, perioperative conduct of anaesthesia, postoperative respiratory complications and their interventions were collected using the data collection tool. The data collection tool was completed by the principal investigator. xiii Results The study showed the prevalence of postoperative respiratory complications following adenotonsillar surgery at the KNH satellite ENT theatre is 41.2%.The most common complications were desaturation 37.6%, laryngospasms 11.1%, apnoea <1% and stridor < 1%. A diagnosis of adenoid hypertrophy, the intraoperative use of morphine and halothane was significantly associated with the postoperative respiratory complications. Oxygen supplementation was the most common intervention used for managing the postoperative respiratory complications. Conclusions The overall prevalence of postoperative respiratory complications in paediatric patients who underwent adenotonsillar surgery was much higher than what is observed in literature. A diagnosis of adenoid hypertrophy, the use of morphine and halothane were associated with postoperative respiratory complications. Desaturation was the most frequent complication while oxygen supplementation was the most common intervention used to manage the respiratory complications.