Our Summary

This study looked at whether giving children the drug gabapentin before ear, nose, or throat surgery could help prevent a condition called emergence delirium (ED). ED can cause both short-term and long-term negative effects after surgery. It’s particularly common after certain kinds of surgery, occurring in about 17.9% of cases. Gabapentin has been used to help with recovery in adults and to decrease ED in some children having eye muscle surgery.

In this study, the researchers gave some children gabapentin before surgery and others a placebo, and then looked to see if there was a difference in rates of ED. They didn’t find a clear statistical difference between the two groups, but they did see fewer cases of ED in the group that got gabapentin.

However, the study had some limitations. The drugs given during surgery weren’t standardized, the number of children in the study was small, and there wasn’t a good tool for identifying ED right after surgery.

Because of these findings, more research is needed to see if gabapentin could be useful in preventing ED after surgery in children.

FAQs

  1. What is emergence delirium (ED) and how common is it after certain surgeries?
  2. Did the study find a significant difference in rates of ED between children who were given gabapentin and those who were given a placebo?
  3. What were the limitations of the study on gabapentin’s effectiveness in preventing ED after surgery in children?

Doctor’s Tip

One helpful tip a doctor might tell a patient about adenoidectomy is to discuss the potential use of gabapentin as a way to prevent emergence delirium after surgery. While more research is needed to confirm its effectiveness, it may be worth considering as part of the overall surgical plan. It’s always important to discuss any concerns or questions with your healthcare provider before undergoing any procedure.

Suitable For

Patients who are typically recommended adenoidectomy include those who have recurrent or chronic infections of the adenoids, obstructive sleep apnea, chronic nasal congestion, chronic sinus infections, or ear infections that are not responsive to other treatments.

Timeline

Before adenoidectomy:

  1. Patient is scheduled for surgery by their healthcare provider after experiencing symptoms such as difficulty breathing, snoring, sleep apnea, or recurrent ear infections.
  2. Patient undergoes pre-operative evaluation and preparation by their healthcare team.
  3. Patient may be given gabapentin or a placebo before surgery to prevent emergence delirium.

After adenoidectomy:

  1. Patient undergoes adenoidectomy surgery to remove the adenoids, typically done under general anesthesia.
  2. Patient is monitored in the recovery room immediately after surgery.
  3. Patient may experience emergence delirium, a condition characterized by confusion, agitation, and disorientation after anesthesia wears off.
  4. Patient is discharged home with post-operative care instructions and pain management medication.
  5. Patient follows up with their healthcare provider for post-operative check-ups and monitoring of recovery progress.

Overall, the timeline before and after adenoidectomy involves pre-operative evaluation, surgery, post-operative monitoring, and recovery. The use of gabapentin before surgery may help prevent emergence delirium, but more research is needed to confirm its effectiveness in children undergoing ear, nose, or throat surgery.

What to Ask Your Doctor

  1. What is an adenoidectomy and why is it recommended for me or my child?
  2. What are the potential risks and complications associated with adenoidectomy?
  3. How will the surgery be performed and what is the recovery process like?
  4. Are there any alternative treatment options to consider before proceeding with adenoidectomy?
  5. Will there be any long-term effects or changes in breathing or voice after the surgery?
  6. What is the success rate of adenoidectomy in improving symptoms or conditions?
  7. How often do complications, such as bleeding or infection, occur after adenoidectomy?
  8. Will there be any restrictions or limitations on activities during the recovery period?
  9. Are there any specific instructions for pain management or post-operative care?
  10. Are there any specific factors or conditions that may increase the risk of complications during or after adenoidectomy?

Reference

Authors: Tuggle E, Gettis M, Brown AM, Jeter L, Fujimoto A. Journal: AANA J. 2023 Oct;91(5):380-384. PMID: 37788180