Intensity of hemorrhage following tonsillectomy

Abstract

Background/Aim. Although post-tonsillectomy hemorrhage is one of the most frequent and potentially life-threatening complications, there is no generally accepted classification of post-operative bleeding intensity. The aim of this study was to evaluate the intensity of post-tonsillectomy hemorrhage according to the five-grade classification. Methods. A total of 408 consecutive patients, aged 2 to 54 years, undergoing elective tonsillectomy, with (n=261) or without (n=147) adenoidectomy, were included in this prospective study. Tonsillectomy was performed under general anesthesia using standard technique of cold dissection with a snare. Any bleeding event was recorded. The severity of post-operative hemorrhage was classified in five grades. Results. In 11 (2.70%) of the patients grade 1 hemorrhage following tonsillectomy occurred, 4 (0.98%) had grade 2 and 2 (0.49%) of the patients had grade 3 post-operative bleeding. Grades 4 and 5 were not recorded, and no patient received a blood transfusion. Conclusion. Post-tonsillectomy hemorrhage can be expected in a small number of patients undergoing tonsillectomy. Hemorrhage is mostly primary and rarely requires treatment under endotracheal anesthesia and blood transfusion.Uvod/Cilj. Iako je krvarenje posle tonzilektomije jedna od najcescih i potencijalno po zivot opasnih komplikacija, do danas ne postoji opste prihvacena klasifikacija intenziteta krvarenja. Cilj ovog rada bio je da se utvrdi intenzitet krvarenja posle tonzilektomije. Metode. Ova prospektivna studija obuhvatila je 408 bolesnika, starosti od 2 do 54 godine, kojima je nacinjena tonzilektomija sa (n = 261) ili bez (n = 147) adenoidektomije. Tonzilektomija je izvodjena u opstoj endotrahejskoj anesteziji standardnom tehnikom ostre i tupe disekcije sa omcom. Belezeno je svako krvarenje, a intenzitet krvarenja klasifikovan je u pet razlicitih stepena. Rezultati. Krvarenje stepena 1 zabelezeno je kod 11 (2,70%) bolesnika. Cetiri (0,98%) bolesnika imala su krvarenje stepena 2 i dva (0,49%) bolesnika krvarenje stepena 3. Nije zabelezeno krvarenje stepena 4 i 5, kao ni primena transfuzija krvi. Zakljucak. Krvarenje kao komplikaciju tonzilektomije mozemo da ocekujemo kod malog broja bolesnika. Krvarenje je uglavnom primarno i retko postoji potreba za ponovnom intervencijom u endotrahejskoj anesteziji i transfuzijom krvi.