[Anesthesiologic and surgical problems in adenotonsillectomy in pediatric patients. Our current trend]. 1998

A Macarone Palmieri, and M Meglio, and D Testa, and M Salafia, and A Iasiello
Istituto di Anestesia e Rianimazione e Terapia Intensiva, Facoltà di Medicina e Chirurgia, Università degli Studi Federico II, Napoli.

OBJECTIVE 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. METHODS A perspective and retrospective clinical study. METHODS University clinic department (operating room and facility). METHODS 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. METHODS 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. METHODS During surgery: ECG, HR, Sat HbO2, non-invasive arterial blood pressure; after surgery: clinical evaluation 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.

UI MeSH Term Description Entries
D007546 Isoquinolines A group of compounds with the heterocyclic ring structure of benzo(c)pyridine. The ring structure is characteristic of the group of opium alkaloids such as papaverine. (From Stedman, 25th ed)
D008297 Male Males
D009467 Neuromuscular Depolarizing Agents Drugs that interrupt transmission at the skeletal neuromuscular junction by causing sustained depolarization of the motor end plate. These agents are primarily used as adjuvants in surgical anesthesia to cause skeletal muscle relaxation. Depolarizing Muscle Relaxants,Muscle Relaxants, Depolarizing,Depolarizing Blockers,Agents, Neuromuscular Depolarizing,Blockers, Depolarizing,Depolarizing Agents, Neuromuscular,Relaxants, Depolarizing Muscle
D012018 Reflex An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord.
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077590 Mivacurium An isoquinoline derivative that is used as a short-acting non-depolarizing agent. BW B1090U,BW-B 1090U,BW-B-1090U,BW-B1090U,Mivacron,Mivacurium Chloride,BW B 1090U,BWB 1090U,BWB1090U
D000233 Adenoidectomy Excision of the adenoids. (Dorland, 28th ed) Adenoidectomies

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