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'Group and save' for paediatric tonsillectomy: is it required routinely?

M-L Montague1, M S W Lee, S S M Hussain

  • 1Department of Otolaryngology, Ninewells Hospital and Medical School, Dundee, Scotland, UK.

The Journal of Laryngology and Otology
|December 13, 2006
PubMed

Insights

Routine serum 'group and save' before pediatric tonsillectomy is generally unnecessary. This practice is not supported by current UK standards or the low rates of complications observed in a prospective study.

Area of Science:

  • Otorhinolaryngology
  • Pediatric Surgery
  • Clinical Practice Guidelines

Background:

  • Establishing current UK practice regarding serum 'group and save' for pediatric tonsillectomy.
  • Assessing the necessity of this practice before routine pediatric tonsillectomy.

Purpose of the Study:

  • To determine the current UK practice for serum 'group and save' in pediatric tonsillectomy.
  • To evaluate the clinical need for pre-tonsillectomy serum 'group and save' in children.

Main Methods:

  • Survey of British Association of Otorhinolaryngologists-Head and Neck Surgeons members.
  • Prospective study of children undergoing tonsillectomy or adenotonsillectomy (Nov 1999-Aug 2002).
  • Analysis of hemorrhage rates, transfusion needs, and return to theatre rates.

Main Results:

  • Only 10.3% of surveyed surgeons routinely performed 'group and save'.
  • Prospective study of 325 children showed low complication rates: 0.6% reactionary hemorrhage, 5.5% secondary hemorrhage.
  • No blood transfusions were required during the study period.

Conclusions:

  • Routine serum 'group and save' for pediatric tonsillectomy is deemed unnecessary.
  • The practice should be reserved for specific clinical circumstances.
  • Findings support a review of current clinical guidelines.
Abstract

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