A significant reduction in paediatric post-tonsillectomy vomiting through audit.

Abstract

INTRODUCTION:

Postoperative vomiting occurs more frequently after tonsillectomy than any other commonly performed paediatric operation. Postoperative vomiting is also the commonest cause of morbidity and re-admission following tonsillectomy. We present a successful completed audit cycle and literature review on the subject.

PATIENTS AND METHODS:

Data on the risk factors for postoperative vomiting, whether the patient vomited and details of the patient's vomitus were collected prospectively on consecutive patients and compared with a gold standard. Changes in practice were agreed and a second cycle performed.

RESULTS:

Two cycles and a total of 107 patients were included in the audit. A significant reduction in vomiting from 27% to 11% was achieved following the introduction of routine use of intravenous dexamethasone during surgery.

CONCLUSIONS:

This simple prospective audit of paediatric post-tonsillectomy vomiting has resulted in a statistically significant reduction in vomiting which would appear to be due to use of intra-operative steroids.

• Authors: A M D Bennett, P J Emery
• Journal: Annals of the Royal College of Surgeons of England (Ann R Coll Surg Engl) Vol. 90 Issue 3 Pg. 226-30 (Apr 2008) ISSN: 1478-7083 [Electronic] England
• PMID: 18430338 (Publication Type: Journal Article)

Chemical References

• Antiemetics
• Glucocorticoids
• Ondansetron
• Dexamethasone

Topics

• Antiemetics (therapeutic use)
• Child
• Dexamethasone (therapeutic use)
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Male
• Medical Audit (methods)
• Ondansetron (therapeutic use)
• Patient Care Planning
• Postoperative Nausea and Vomiting (etiology, prevention & control)
• Prospective Studies
• Tonsillectomy (adverse effects)