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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 1998 December;64(12):545-52

language: Italian

Anaesthetic and surgical problems of adenotonsillectomy in children. Personal present trend

Macarone Palmieri A. 1, Meglio M. 1, Testa D. 2, Salafia M. 2, Iasiello A. 1

1 Università degli Studi «Federico II» - Napoli, Facoltà di Medicina e Chirurgia, Istituto di Anestesia e Rianimazione e Terapia Intensiva;
2 Università degli Studi «Federico II» - Napoli, Facoltà di Medicina e Chirurgia, Istituto di Patologia Clinica Otorinolaringoiatrica e di Foniatria


Aim. To verify, in dissection adenotonsillectomy (AT) performed in Rose position under general anaesthesia with oro-tracheal intubation, the following: 1) the ability of tramadol to produce an effective intra- and postoperative analgesia without any considerable side effects or interferences with the normal post-surgical course of the operation; 2) the possibility of obtaining, thanks to mivacurium, a myoresolution closer both to surgical times of the operation and to the necessity of a fast recovering of the pharyngo-laryngeal reflexes.
Experimental design. A perspective and retrospective clinical study.
Setting. University clinic department (operating room and facility).
Patients. 110 patients submitted to adenotonsillectomy, aged 4-10, belonging to the I-II ASA categories and not taking any drug for at least 30 days.
Interventions. Intravenous pre-medication with tramadol 2 mg/kg; myoresolution with mivacurium 0.2 mg/kg; postoperative analgesia with tramadol 2 mg/kg i.m. one hour after the first administration and, with an equivalent oral dose of tramadol, six hours later.
Measurements. During surgery: ECG, HR, Sat HbO2, non-invasive arterial blood pressure; after surgery: clinical evalutation of pain, through a three-point scale, and of the surgical course.
Results. Good analgesical level both during and after surgery; myoresolution especially suitable to adenotonsillectomy duration and characteristics; no considerable complications.
Conclusions. Tramadol intra- and postoperative analgesia and mivacurium myoresolution represents, in personal opinion, an efficient approach to dissection adenotonsillectomy performed in children under general anaesthesia.

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