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

Abstract

Objective: 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.

Methods: 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.

Results: 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]).

Conclusion: 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.