While searching for risk factors in outpatient tonsillectomy, and disregarding the effect of perioperative drugs, Gerber et al1 and other authors2,3 continue to ignore the most common cause of postoperative respiratory compromise, oversedation.4 Many such patients require overnight observation.
Since 1991, tonsillectomy and adenotonsillectomy have nearly all been outpatient procedures at the Kaiser Permanente Medical Center, Santa Clara, Calif. Little or no preoperative medication is used and the anesthetic focus is on rapid recovery. About 1000 of these operations have been performed, many for obstructive sleep apnea in young children, with few postoperative problems and routinely favorable outcomes.
Remarkably, the relationship between overmedication and early posttonsillectomy complication is yet to be appreciated by our specialty.
Gaskill JR. Overmedication in Outpatient Tonsillectomy. Arch Otolaryngol Head Neck Surg. 1997;123(1):116–117. doi:10.1001/archotol.1997.01900010126024
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