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Investigating the effect of a nasal decongestant on post-adenotonsillectomy respiratory complications in 25 paediatric patients with obstructive sleep apnoea: a pilot study

Published online by Cambridge University Press:  01 February 2019

E Shamil ,
M J Rouhani ,
A C Panayi ,
J Lynch ,
J Tysome  and
N Jonas
E Shamil*
Affiliation:
ENT Department, Cambridge University Hospitals NHS Foundation Trust, UK Specialist Registrar in Otolaryngology, London Deanery, UK
M J Rouhani
Affiliation:
Specialist Registrar in Otolaryngology, London Deanery, UK School of Clinical Medicine, University of Cambridge, UK
A C Panayi
Affiliation:
School of Clinical Medicine, University of Cambridge, UK
J Lynch
Affiliation:
Anaesthetic Department, Cambridge University Hospitals NHS Foundation Trust, UK
J Tysome
Affiliation:
ENT Department, Cambridge University Hospitals NHS Foundation Trust, UK
N Jonas
Affiliation:
ENT Department, Cambridge University Hospitals NHS Foundation Trust, UK
*
Author for correspondence: Mr Eamon Shamil Specialist Registrar in Otolaryngology, London Deanery, UK E-mail: eamon.shamil@nhs.net
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Abstract

Objective

Adenotonsillectomy is frequently performed for obstructive sleep apnoea, but is associated with post-operative respiratory morbidity. This study assessed the effect of paediatric Otrivine (0.05 per cent xylometazoline hydrochloride) on post-operative respiratory compromise.

Methods

Paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea were included. The control group (n = 24) received no intervention and the intervention group (n = 25) received intra-operative paediatric Otrivine during induction using a nasal patty. Post-operative outcomes included pain, respiratory distress signs and medical intervention level required (simple, intermediate and major).

Results

Post-operative respiratory distress signs were exhibited by 4 per cent of the Otrivine group and 21 per cent of the control group. Sixty-eight per cent of the Otrivine group required simple medical interventions post-operatively, compared to 42 per cent of the control group. In the Otrivine group, 4 per cent required intermediate interventions; none required major interventions. In the control group, 12.5 per cent required both intermediate and major interventions. Fifty per cent of the control group reported pain post-operatively, compared with 40 per cent in the Otrivine group.

Conclusion

Intra-operative paediatric Otrivine may reduce post-operative respiratory compromise in paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea. A randomised controlled trial is required.

Keywords

Sleep Apnea, ObstructiveSleep-Disordered BreathingDecongestants
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 2 , February 2019 , pp. 110 - 114
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Mr E Shamil takes responsibility for the integrity of the content of the paper

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