PREVALENCE OF POST TONSIL BLEEDING IN CHILDREN SCHEDULE FOR TONSILLECTOMY AND ADENOIDECTOMY; A CROSS-SECTIONAL STUDY

Abstract

Introduction: Tonsillectomy and adenoidectomy are among the most common surgical procedures performed in children to address recurrent tonsillitis and obstructive sleep-disordered breathing (SDB).

Material & Methods: A cross-sectional study was conducted on 246 children scheduled for tonsillectomy and adenoidectomy. Data were collected on various demographic and clinical variables, including age, gender, weight, pre-existing conditions (such as asthma, allergies, and sleep apnea), ASA classification, and primary diagnosis. Post-tonsil bleeding was categorized as primary (within the first 24 hours post-surgery) or secondary (after 24 hours).

Results: In a study of 246 children undergoing tonsillectomy and adenoidectomy, 36 (14.6%) experienced post-tonsil bleeding. The highest incidence was in middle childhood (6-11 years) with a significant p-value of 0.01. Males had a higher incidence of bleeding (15.9%) compared to females (13.0%) with P=0.05. Children weighing less than 15 kg were more prone to bleeding (22.2%, p=0.01). Pre-existing conditions such as sleep apnea significantly increased bleeding risk (25%, p=0.01). General anesthesia was associated with a bleeding rate of 14.7% (p=0.05). Higher ASA classifications correlated with increased bleeding, particularly ASA III (37.5%, p=0.01). Obstructive sleep-disordered breathing (SDB) was also a significant risk factor (18.2%, p=0.01). Primary bleeding was characterized by 40% minimal, 30% moderate, 20% severe, and 10% life-threatening cases, with no significant difference in severity compared to secondary bleeding. The hemorrhage location was primarily in the right tonsil bed (50%) for both primary and secondary bleeding, with no significant positional differences.

Conclusion: In conclusion, this study identifies key risk factors for post-tonsil bleeding in children undergoing tonsillectomy and adenoidectomy, including age, weight, pre-existing conditions, ASA classification, and type of anesthesia used.