A 6-year old male presents to the office with a history of snoring, mouth breathing, restless sleeping at night, and waking during the night. His parents describe periods of observed apnea for several seconds. He has some dysphagia for solid food and is often tired or cranky during the day. A tape recording of his breathing at night has been made. On physical examination, the child has 4+ enlarged tonsils, and enlarged tonsils and adenoids are confirmed on lateral neck radiograph. A tonsillectomy and adenoidectomy are performed under general anesthesia in an outpatient facility. Postoperatively, the family contacts the surgeon’s office on several occasions with questions regarding postoperative fears, poor oral intake, possible dehydration, and a stiff neck. These symptoms resolve over the next 7 to 10 days.
Description of Procedure: Intraservice includes reassuring and comforting the child during induction of anesthesia; monitoring for sudden airway obstruction during induction of anesthesia; positioning patient; placing a mouth gag; removing tonsils and adenoids; obtaining hemostasis with electrocautery; and placing a gastric tube in the stomach to remove secretions and blood.
