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Efficacy of Gastric Aspiration in Reducing Posttonsillectomy Vomiting
Jacqueline E. Jones, MD;
Abtin Tabaee, MD;
Robert Glasgold, MD;
Matthew C. Gomillion, MD
Arch Otolaryngol Head Neck Surg. 2001;127:980-984.
Objective To determine the effectiveness of postoperative gastric decompression
in reducing the incidence and complications associated with vomiting following
tonsillectomy.
Design A prospective, randomized controlled study.
Setting Private office and clinic of a university teaching hospital and research
center.
Patients Eighty pediatric patients ranging in age from 22 months to 11 years,
American Society of Anesthesiologists class I or II, undergoing tonsillectomy
with or without adenoidectomy were enrolled in the study. Six were excluded
from the final analysis, 5 because of failure of the parents to complete and
return the data forms and 1 because of postoperative bleeding. Of the 74 patients
included in the study, 35 were in the control group and 39 were in the study
group.
Interventions The 39 patients in the study group underwent postoperative aspiration
of gastric contents with an orogastric tube placed under direct visualization
while the patient was still under general anesthesia. The 35 patients in the
control group did not undergo gastric aspiration following surgery.
Main Outcome Measures The incidence of vomiting, the number of episodes of vomiting before
and after hospital discharge, the total volume of emesis, the postoperative
length of stay, the need for rescue antiemetic prophylaxis, and the number
of readmissions to the hospital for persistent vomiting were noted.
Results No statistically significant difference (P<.05)
was noted between the control group and the study group for the percentage
of patients experiencing vomiting (74% vs 85%), the mean number of episodes
of vomiting before (2.6 vs 2.8) and after (0.8 vs 0.7) hospital discharge,
the mean volume of emesis (157 mL vs 222 mL), the postoperative length of
stay (394 minutes vs 334 minutes), the percentage of patients requiring rescue
antiemetics (34% [12 patients] vs 33% [13 patients]), and the percentage of
unplanned admissions because of vomiting (9% [3 patients] vs 15% [6 patients]).
Conclusion Our results indicate that gastric aspiration does not decrease the incidence
of vomiting following tonsillectomy.
From the Departments of Otorhinolaryngology (Drs Jones, Tabaee, and
Glasgold) and Anesthesiology (Dr Gomillion), Weill College of Medicine at
Cornell University, New York, NY.
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