Amygdalectomie en ambulatoire chez l’enfant

Abstract

Tonsillectomy may be performed as an outpatient procedure because post-tonsillectomy hemorrhages occur during the first few hours, and therefore are diagnosed before discharge, or occur after the sixth day. Nevertheless, not all patients are eligible for outpatient tonsillectomy. Both the ENT surgeon and the anesthesiologist must identify children who cannot be operated as outpatients because they do not satisfy the social criteria for discharge on the day of surgery (their parents do not speak French, they live too far from the hospital, etc.) or because they have individual risk factors for complications unrelated to their tonsils, such as bleeding disorders or related to their tonsils, such as a history of obstructive sleep apnea due to enlarged tonsils, particularly for young children. The anesthetic protocol must minimize the risk of postoperative nausea and vomiting. After tonsillectomy, the child may be discharged from the recovery room if he is fully awake, with no dyspnea and no oral bleeding, and is able to swallow liquids, without repeated vomiting.