Sickle Cell Disease and Pediatric Adenotonsillectomy

Abstract

Objective: Determine the safety of a primarily outpatient management protocol for children with sickle cell disease undergoing adenotonsillectomy. Method: A retrospective chart review was conducted of children with sickle cell disease undergoing adenotonsillectomy over a four year period beginning January 2007 at an academic tertiary care facility. Preoperatively patients underwent transfusion for hemoglobin less than 10g/dL. Postoperatively, they were monitored overnight and discharged the following day when possible. Results: Fifteen pediatric patients with homozygous sickle cell disease and one patient with sickle beta thalassemia disease were identified, all of whom underwent adenotonsillectomy. The majority of patients (11) were discharged on the first postoperative day with the average length of postoperative admission for all patients being 1.5 days (range, 1-5). Two patients (13 percent) experienced postoperative pain crises. There were no cases of postoperative bleeding, CVA, or acute chest syndrome. Conclusion: Adenotonsillectomy in patients with sickle cell disease can be performed safely and effectively with careful outpatient preoperative management and brief postoperative hospitalization.