Tonsillectomy – A Comparative Study of GA or LA
Mohammad Ashraf
1
, Sadia Ashraf
2*
, Ibrahim al Jabr
3
1
Assistant Professor, Dept. of ENT, Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh.
2
Assistant Professor, Dept. of Obst. & Gynae, Career Institute of Medical Sciences, Lucknow, Uttar Pradesh.
3
Assistant Professor, Dept. of Surgery, College of Medicine, King Faisal University, KSA.
65 | Page
Original Article
www.iabcr.org International Archives of BioMedical and Clinical Research | Jan-Mar 2017 | Vol 3 | Issue 1
Section – ENT
ABSTRACT
Background: Ethically it is our jurisdiction to decide upon the medical procedure we undertake after weighing
the risk benefit ratio. Tonsillectomy is conventionally operated under general anesthesia but it has its own merits
and demerits. The aim of the study was to analyse the better procedure.
Methods: Hundred patients were operated in the medical college over period of two years in HIMS Barabanki
and Govt medical college Kannauj. Seventy patients were operated under general anesthesia and another thirty
under local anesthesia. Results: The total operation time, VAS, blood loss, complications, cost effectiveness, bed
occupancy, patient turnover rate and patient satisfaction was better in surgical exercise done under local
anesthesia when compared to general anesthesia. Conclusions: Tonsillectomy done under local anesthesia
definitely has an edge over the general anesthesia.
Key words: Tonsillectomy, General Anesthesia, Local Anesthesia.
INTRODUCTION
Tonsillectomy is a common operative procedure for
Otorhinolaryngologist and is usually done for chronic
recurrent tonsillitis, tonsillolith, papilloma tonsil,
subsequent to quinsy, OSA and as approach for other
procedures. In our traditional medical practice tonsils are
usually operated under general anesthesia by dissection
method. However, there are many different ways to remove
the tonsils like coblator, laser, electrocautery, harmonic
scalpel etc.
Tonsillectomy under local anesthesia is not new but not
preferred in children, apprehensive females, although has
edge over general anesthesia in cooperative patients. The
patients were very satisfied and happy to recommend others.
METHODS
This was a prospective study. Hundred patients were
selected randomly over period of two years at HIMS,
Barabanki and government medical college, Kannauj.
Of the hundred patients seventy were operated under general
anesthesia and thirty under local anesthesia. All the patients
selected were investigated and when found medically fit
were selected for study. Specific relevant investigation like
platelet count and INR was analyzed.
General anesthesia was given by Draggers work station with
inbuilt ventilator. Nasal and oral intubation was used
depending upon whether the adenoid was also to be removed
or not. Local tonsillectomy was performed after spraying
10% xylocaine thrice and then painting with 4% xylocaine,
lastly, we blocked the palatine nerves and superior pole,
inferior pole and anterior tonsillar pillar with mixed solution
of 2% injection xylocaine and 0.5% bupivacaine. Two hours
before local tonsillectomy, two tablets of phnergan is given
and injection fortwin and calmpose just before surgery
intramuscularly.
We followed our traditional dissection method and used
snare to remove the tonsils in both the groups. Various
parameters like time taken, blood loss, post-operative pain,
complication rate and patient satisfaction was analyzed.
RESULTS
Access this article online
Website:
www.iabcr.org
Quick Response code
DOI:
10.21276/iabcr.2017.3.1.18
Received:14.07.15| Revised:28.07.15| Accepted:30.07.15
Corresponding Author
Dr. Sadia Ashraf, Assistant Professor, Dept. of Obst. &
Gynae, Career Institute of Medical Sciences, Lucknow, Uttar
Pradesh.
Copyright: © the author(s) and publisher. IABCR is an official publication of
Ibn Sina Academy of Medieval Medicine & Sciences, registered in 2001 under
Indian Trusts Act, 1882. This is an open access article distributed under the
terms of the Creative Commons Attribution Non-commercial License, which
permits unrestricted non-commercial use, distribution, and reproduction in any
medium, provided the original work is properly cited.