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Hypopharyngeal packing during adenotonsillectomy by cold dissection in children: a randomized controlled trial

Luciana Pimentel Oppermann1, José Faibes Lubianca Neto2, Renata Loss Drummond3

  • 1Department of Pediatric Otolaryngology of Hospital da Criança Santo Antônio/Postgraduate Program in Pediatrics, Irmandade da Santa Casa de Misericórdia de Porto Alegre/Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. luopp24@hotmail.com.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|May 21, 2020
PubMed

Insights

Hypopharyngeal packing (HP) did not reduce nausea and vomiting after pediatric adenotonsillectomy. This study found no significant benefit of HP in preventing postoperative nausea and vomiting (PONV) in children undergoing this common surgery.

Area of Science:

  • Pediatric Otolaryngology
  • Anesthesiology
  • Surgical Outcomes Research

Background:

  • Postoperative nausea and vomiting (PONV) affects up to 70% of children after adenotonsillectomy.
  • Ingested blood during the procedure is a potential cause of emesis.
  • Hypopharyngeal packing (HP) is used to prevent blood swallowing, but its efficacy in pediatric adenotonsillectomy is unstudied.

Purpose of the Study:

  • To evaluate the effectiveness of hypopharyngeal packing (HP) in preventing postoperative nausea and vomiting (PONV) in children undergoing adenotonsillectomy.
  • To address the lack of research on HP's impact on PONV in pediatric adenotonsillectomy patients.

Main Methods:

  • A randomized, double-blinded, controlled trial was conducted with children aged 4-16 years undergoing adenotonsillectomy.
  • 129 participants were randomized to receive either HP or no packing during surgery.
  • Postoperative nausea and vomiting (PONV) occurrence was assessed within 24 hours, with relative risk calculated.

Main Results:

  • The incidence of PONV was 20.3% in the hypopharyngeal packing (HP) group and 23.1% in the control group.
  • The relative risk for PONV with HP was 0.88 (95% CI 0.46-1.70), indicating no significant difference.
  • Baseline characteristics and surgical variables were similar between the groups.

Conclusions:

  • Hypopharyngeal packing (HP) does not provide a significant benefit in preventing postoperative nausea and vomiting (PONV) in children undergoing adenotonsillectomy.
  • The findings suggest that HP is not an effective strategy for reducing PONV in this pediatric surgical population.
Abstract

Keywords:
ChildrenPostoperative nausea and vomitingSurgical gauze packingTonsillectomy

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