Shorter post-operative recovery stay following outpatient tonsillectomy is safe, cost-efficient

Children undergoing tonsillectomies will be happy to know they should be able to go home shortly after surgery. A new UCLA study showed that it can be safe and cost-efficient to discharge pediatric tonsillectomy patients after a short post-operative recovery period at an outpatient surgery center.

The study found no increased complications with an average discharge time of 1 hour and 47 minutes, which was significantly less time than prior studies, which showed that patients should remain at least 2 hours and 18 minutes.

"With increasing healthcare costs and pressures to perform outpatient surgeries in a more efficient, yet safe, fashion this study lends support to potential safety of shorter and more cost-effective stays," said the study's author, Dr. Nina Shapiro, associate professor of pediatric otolaryngology at Mattel Children's Hospital at UCLA.

In the first study of its kind to look at a very large patient population, researchers reviewed the records of almost 800 pediatric patients that spanned a period of more than seven and a half years. The findings are reported in the Nov. 29 issue of the peer-reviewed International Journal of Pediatric Otorhinolaryngology.

"After analyzing so many records, the biggest surprise was the lack of complications in patients who were discharged after a shorter recovery period," added Shapiro. "This is especially good news for parents and children who want to go home as soon as possible after surgery."

Patients remain in recovery after tonsillectomy so that medical staff can monitor the child after emerging from anesthesia, to allow for the child to wake up to their pre-surgical condition and to monitor for any signs of adverse reaction to general anesthesia or other unexpected problems. Patients are typically cleared for discharge once they are alert, their vital signs are stable and they have fully woken up from the anesthesia.

"However, despite this encouraging data, we must remember to evaluate each child individually in the early post-operative period, and be prepared to monitor those children who require longer observation times," Shapiro said.

Tonsils are oval-shaped masses of lymphatic tissue located at the back of the throat that aid the body in fighting infections. However, they may become enlarged to the point of causing childhood breathing trouble, manifested most commonly as snoring, sleep problems and obstructive sleep apnea.

Approximately 500,000 tonsillectomies are performed on children each year, making it the second-most common childhood surgery performed in the United States.

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Co-authors of the study included Nader Kalantar and Christopher Takehana. The researchers received no financial support for this study.

Mattel Children's Hospital at UCLA is the highest rated children's hospital in Southern California and is a vital component of UCLA Medical Center, consistently ranked "Best in the West" in U.S. News & World Report's annual survey. The hospital offers a full spectrum of primary and specialized medical care for infants, children and adolescents. The mission of Mattel Children's Hospital at UCLA is to provide state of-the-art treatment for children in a compassionate atmosphere, as well as to improve the understanding and treatment of pediatric diseases. For more information, please visit http://www.mattel.ucla.edu/.


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