Factors Influencing Post-Operative Oral Intake Following Tonsillectomy in Children with OSA

To investigate the factors that influence oral intake in the first 24 hours following tonsillectomy in children performed for Obstructive Sleep Apnea (OSA) and their impact on dehydration in the 30-day post-operative period.

A retrospective cohort study was conducted reviewing the records of 1200 patients who underwent tonsillectomy. Patients were excluded if they were 19 years or older, did not have a diagnosis of SDB (sleep disordered breathing) or OSA (obstructive sleep apnea), or their oral intake was not recorded for 24 hours post-operatively. Primary outcomes were 24-hour post-operative oral intake controlled for body weight and post-operative dehydration determined by ED visits or phone calls for dehydration within 30 days post-operatively.

357 patients were included. Higher BMI (body mass index; r = -.261) older age (r = -.393), longer operative time (r = -.125), longer time under anesthesia (r = -.186), higher apnea-hypopnea index (AHI; r = -.171), higher pain scores (r = -.239), and the presence of a resident (P = .028) were all significantly associated with lower oral intake. Post-operative oral intake did not have a significant effect on post-operative dehydration events (OR = 0.995, 95% CI [0.975-1.015]).

Our findings suggest that age, BMI, operative time, time under anesthesia, AHI, pain, and the presence of a resident were significantly associated with post-operative oral intake following tonsillectomy. Post-operative oral intake was not associated with dehydration in the 30-day surgical recovery period.