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[Risk of postoperative hemorrhage in tonsillectomy. A comparison between general anesthesia and local anesthesia]
1Abteilung Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm.
Background:
Postoperative bleeding after tonsillectomy is still a life-threatening problem. The incidence of postoperative bleeding, as well as many factors (kind of surgery, hemostasic problems) affecting this risk have been investigated. A possible factor that has not been well studied is the used anaesthetic procedure.
Methods:
A prospective study was completed comparing the risk of postoperative bleeding in patients operated in local vs. general anaesthesia.
Results:
The study enrolled 1063 patients, who consecutively underwent tonsillectomy. In 16 (4.12%) of 388 patients operated under general and 51 (7.55%) of 675 patients operated under local anaesthesia postoperative bleeding occurred. After local anaesthesia postoperative bleeding was seen mainly at the day of operation (46 of 51), there was no late bleeding after the 6th postoperative day. After general anaesthesia in 6 of 16 cases postoperative bleeding occurred after the 6th postoperative day.
Discussion:
Postoperative bleeding occurs more frequent in patients who underwent tonsillectomy in local anaesthesia. The risk of late postoperative bleeding however is higher with tonsillectomy in general anaesthesia.