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New in CJA March 2016 Issue: Drs. Ahmad & Sommerfreund discuss anesthesia for pediatric tonsillectomy

Can J Anesth. 2016 Mar;63:256-261.

A new analgesic paradigm for pediatric tonsillectomy: Are we dragging our heels?

Ahmad M, Sommerfreund D

Authors Dr. Mohamad Ahmad (Director of Pediatric Anesthesia) and Dr. David Sommerfreund are anesthesiologists primarily practising at Victoria Hospital (Children's Hospital), in the Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, Western University. To learn more about their research and clinical work, please visit Pediatric Anesthesia site.

"In pediatrics, postoperative analgesic options are relatively limited and the barriers to optimal analgesia are numerous. Currently available analgesics have various undesirable side effects, including sedation, respiratory depression, or interference with coagulation. In addition, various regulatory, scientific, industry, physician, and parental barriers exist.

Arguably, there is no greater need for better analgesia than among children undergoing tonsillectomy or adenotonsillectomy. The pain of tonsillectomy lasts longer than most other surgeries—four to seven days1—with residual pain on swallowing often lasting longer. The very serious risk of postoperative hemorrhage is traditionally the foremost concern after tonsillectomy and occurs in approximately 3% of patients.2 In comparison, significant pain after inguinal hernia repair and other common pediatric surgeries typically lasts only one to two days. In such cases, children can return to a normal routine by three days1 and bleeding is a negligible concern ...(Ahmad 2016, 256)

Continue reading the full-text article in CJA