Abstract:
Background: Adenotonsillectomy remains a burden leading to high morbidity and mortality due
to complications at medical settings. This study aimed to identify perioperative complications of
adenotonsillectomy at CHUB and associated factors.
Method: Prospective observational study was conducted among 72 pediatric patients aged 0 to
15 years at Centre Hospitalier Universitaire de Butare from September 2018 to February 2019.
Results: The study population mean age was 59.3 months (range 51.1 – 67.6months), and 58.3%
were male. The majority were ASA1 (75%). The rate of Adenoidectomy, Adenotonsillectomy
and Tonsillectomy was 4.2%, 80.6% and 15.3% respectively. Intraoperative complications were
observed in 26.4% and were mainly respiratory (25%). Postoperatively, complications occurred
in 37.5% and were mostly pain, desaturation, and PONV. A chi square test was done to identify
association between different factors such as age, comorbidity, and occurrence of intraoperative
and postoperative complications. Intraoperative complications were significantly associated with
young age below 3 years O.R 0.12 [0.03 – 0.44] with a CI 95% p 0.001. We didn’t identify any
factor predicting postoperative complications.
Conclusion:
Younger children undergoing adenotonsillectomy encounter more intraoperative complications,
and as such they should be assessed and anesthetized by more skilled healthcare providers.
We recognize that our sample size was small, and we recommend this study to be repeated on a
larger scale. We would recommend regular daytime oximetry and specific cardiologist review
for children presenting with severe OSA to assess for pulmonary hypertension as part of the
preoperative evaluation
