JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

Anesth Analg 2007; 105:1513-
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000287015.05692.04
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Edler, A.
Right arrow Articles by Golianu, B.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Edler, A.
Right arrow Articles by Golianu, B.

LETTER TO THE EDITOR

Factors Influencing Postanesthesia Recovery After Pediatric Ambulatory Tonsillectomy and Adenoidectomy

Alice Edler, MD, MA, MPH, and Brenda Golianu, MD

Stanford University School of Medicine; Stanford, California

In Response:

Pain scores, were assessed at admission to post anesthesia care unit and every 15 min until 120 min or discharge, whichever came first. These scores were entered as variables into the initial regression modeling. In this univariant analysis, the pain scores were not found to be correlated with length of stay. Additionally, when forced into later regression equations, they again were not significant contributors to length of stay based on the change in the Wald value. We believe that the reason pain was not a significant contributor to the model was that it was adequately controlled with opioid administration in the postanesthesia care unit. The amount of opioid is reported as "morphine equivalent dose" based on standard equivalent opioid dosing regimens. In short, yes, pain is an important contributor, but it appeared that we do a good job of controlling pain with analgesic medication. The statistical significance of episodes of airway compromise, however, does bring up the issue "Are we overmedicating to relieve pain at the expense of the airway?"

Management of postoperative nausea and vomiting is a controversial topic in our practice. As Lane et al. (1) noted, there are multiple regimens for its prevention and children do not readily fall into the Apfel prognostic scheme for making antiemetic choices (2). The selection of antiemetic was determined by dual study enrollment. To standardize the regimen, a dummy variable of "ondansetron equivalent dose" was created to allow for a larger sampling population.

We apologize that the pain scores were not included in the final report (3). Although they did not influence the length of stay, further studies are needed to investigate the relationship between airway compromise and opioid administration in children during their postanesthesia recovery period.

REFERENCES

  1. Lane MH, Flynn F, Hepburn LH, Jaggar S. Factors influencing postanesthesia recovery after pediatric ambulatory tonsillectomy and adenoidectomy. Anesth Anal 2007;105:1512–3[Free Full Text]
  2. Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N, IMPACT investigators. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N. Eng J Med 2004;350:2441–51
  3. Edler AA, Mariano ER, Golianu B, Kuan C, Pentcheva K. An analysis of factors influencing postanesthesia recovery after pediatric ambulatory tonsillectomy and adenoidectomy. Anesth Analg 2007;104:784–9[Abstract/Free Full Text]



This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
C.-M. Lim
Hypothermia in Acute Lung Injury: Reduction of Barotrauma or Biotrauma?
Anesth. Analg., November 1, 2007; 105(5): 1514 - 1514.
[Full Text] [PDF]

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Edler, A.
Right arrow Articles by Golianu, B.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Edler, A.
Right arrow Articles by Golianu, B.

Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press