Our Summary

This research paper is about children who have Obstructive Sleep Apnoea (OSA) - a condition that interrupts their breathing while they sleep. Often, these children need to have their adenoids and tonsils removed to help with the condition. The traditional approach has been to keep these children in hospital overnight after the operation to monitor their breathing. But recently, there’s been a trend towards sending children home on the same day as their operation.

The researchers looked at 15 studies, covering over 10,000 patients, to see whether same-day discharge is safe. They found that the methods for diagnosing OSA and deciding who could go home on the same day varied a lot between the studies. However, on average, 96.1% of children who were planned for same-day discharge were able to go home as planned.

In terms of safety, the rates of breathing problems after the operation ranged from 0%-27.3%. The need for further treatment to help with breathing was between 0.4%-6.8%. No deaths were reported in any of the studies.

The researchers concluded that same-day discharge seems safe for carefully chosen children. However, they also highlighted the need for more detailed study to identify which children are most suitable for same-day discharge. This could help increase confidence in this approach and encourage more hospitals to adopt it.

FAQs

  1. What is the traditional approach for children with Obstructive Sleep Apnoea (OSA) who have had their adenoids and tonsils removed?
  2. What percentage of children were able to be discharged on the same day as their operation, according to the research?
  3. What are the potential risks of same-day discharge and what did the researchers conclude about its safety?

Doctor’s Tip

A helpful tip a doctor might tell a patient about adenoidectomy is to follow post-operative care instructions carefully, including taking prescribed pain medication, eating soft foods, and avoiding strenuous activities. It’s also important to keep the throat hydrated by drinking plenty of fluids and to watch for signs of infection, such as fever or increased pain. If any concerns arise, the patient should contact their healthcare provider immediately.

Suitable For

Children who have Obstructive Sleep Apnoea (OSA) and need to have their adenoids and tonsils removed are typically recommended adenoidectomy. These children may experience interrupted breathing while they sleep, leading to symptoms such as snoring, gasping, and daytime fatigue. Adenoidectomy is often recommended as a treatment for OSA in children, as removing the adenoids can help improve their breathing and quality of sleep.

In the study mentioned above, the researchers found that same-day discharge after adenoidectomy for children with OSA is generally safe, with high rates of successful same-day discharge and low rates of post-operative complications. However, it is important to carefully select which children are suitable for same-day discharge to ensure their safety and well-being.

Overall, children who have OSA and require adenoidectomy may be recommended for the procedure to improve their breathing and alleviate symptoms associated with OSA. Same-day discharge after adenoidectomy may be a safe and effective option for carefully selected children, but further research is needed to determine the best criteria for patient selection and ensure the safety and success of this approach.

Timeline

Before adenoidectomy:

  1. Child is diagnosed with Obstructive Sleep Apnoea (OSA) and recommended for adenoidectomy.
  2. Pre-operative assessment is conducted to evaluate the child’s overall health and suitability for surgery.
  3. Surgery is scheduled and the child and their family are provided with pre-operative instructions.
  4. Child undergoes adenoidectomy procedure under general anesthesia.
  5. Child is monitored post-operatively in the hospital overnight to ensure no breathing complications.

After adenoidectomy:

  1. Child is monitored closely for any immediate post-operative complications in the hospital.
  2. Child is assessed for readiness to be discharged same-day based on criteria set by the medical team.
  3. Child is discharged home on the same day if deemed suitable for same-day discharge.
  4. Family is provided with post-operative care instructions and advised on signs of potential complications.
  5. Child is followed up with by the medical team to monitor recovery and ensure no further breathing problems occur.

What to Ask Your Doctor

  1. What is an adenoidectomy and why is it recommended for my child with Obstructive Sleep Apnoea (OSA)?
  2. What are the potential risks and complications associated with an adenoidectomy procedure?
  3. How will you determine if my child is a suitable candidate for same-day discharge after the adenoidectomy?
  4. What criteria will you use to decide if my child can be safely discharged on the same day of the surgery?
  5. What measures will be in place to monitor my child’s breathing and overall condition after the adenoidectomy?
  6. What symptoms should I watch for at home that may indicate a complication following the adenoidectomy?
  7. How should I care for my child at home following the adenoidectomy procedure?
  8. What follow-up appointments will be necessary after the adenoidectomy?
  9. Are there any specific instructions or restrictions my child should follow post-surgery?
  10. Are there any alternative treatment options or approaches that should be considered for my child with OSA?

Reference

Authors: Gowda S, Leong WS, Edafe O. Journal: Clin Otolaryngol. 2022 Sep;47(5):553-560. doi: 10.1111/coa.13946. Epub 2022 Jun 4. PMID: 35603525