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Inadequate analgesic prescription increases secondary post-tonsillectomy bleed rates: a completed audit loop

Published online by Cambridge University Press:  01 August 2007

O Alhamarneh ,
H Raja  and
R J A England
O Alhamarneh*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hull Royal Infirmary, UK
H Raja
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hull Royal Infirmary, UK
R J A England
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hull Royal Infirmary, UK
*
Address for correspondence: Mr Osama Alhamarneh, Department of Otolaryngology Head and Neck Surgery, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, UK. E-mail: [email protected]
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Abstract

A significantly greater than normal secondary haemorrhage rate was noted in patients who had undergone tonsillectomy or adenotonsillectomy as waiting list ‘initiative’ cases within an alternative healthcare provider setting, compared with patients undergoing the same surgery within a primary healthcare trust (17.8 vs 3.9 per cent, respectively; p < 0.001).

An audit was therefore set up to examine any variations in practice which may have caused this difference. Duration of analgesic prescription was identified as the only significant variable, and this was subsequently altered from three to seven days, to match the primary trust's protocol. Completion of the audit loop showed that the difference in secondary haemorrhage rates between the two provider sites had ceased to be significant (5.9 vs 3 per cent; p > 0.1). We conclude that adequate analgesia, for the first week post-tonsillectomy, is essential in order to keep the secondary haemorrhage rate within an acceptable range.

Keywords

TonsillectomyComplicationsHaemorrhagePostoperative PainAnalgesiaGreat Britain
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 7 , July 2008 , pp. 719 - 721
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented (as a free paper presentation) at the 12th British Academic Conference in Otolaryngology, 6 July 2006, Birmingham, UK.

References

1 Husband, AD, Davis, A. Pain after tonsillectomy. Clin Otolaryngol 1996;21:99–101CrossRefGoogle ScholarPubMed
2 Brodsky, L, Radomski, K, Gendler, J. The effect of post-operative instructions on recovery after tonsillectomy and adenoidectomy. J Pediatr Otorhinolaryngol 1993;25:133–40CrossRefGoogle ScholarPubMed
3 Cook, JA, Murrant, NJ, Evans, KL, Lavelle, RJ. A randomised trial of three post-tonsillectomy diets. Clin Otolaryngol 1992;17:28–31CrossRefGoogle ScholarPubMed
4 Toma, AG, Blanchard, J, Eynon-Lewis, N, Bridger, MW. Post- tonsillectomy pain: the first ten days. J Laryngol Otol 1995;109:963–4CrossRefGoogle ScholarPubMed
5 Murthy, P, Laing, MR. Dissection tonsillectomy: pattern of post-operative pain, medication and resumption of normal activity. J Laryngol Otol 1998;112:41–4CrossRefGoogle ScholarPubMed
6 National Prospective Tonsillectomy Audit. Final Report of an Audit Carried Out in England and Northern Ireland Between July 2003 and September 2004. London: The Royal College of Surgeons of England, 2005Google Scholar