PREANESTHETIC SEDATION OF CHILDREN: Analysis of the Effects for Tonsillectomy and Adenoidectomy

Abstract

THE NECESSITY for preanesthetic sedation before tonsillectomy and adenoidectomy in children is a much debated question. Many otolaryngologists avoid giving sedation because of the danger of depression of the cough reflex and the attendant hazard of aspiration of blood and debris into the lungs. On the other hand, pediatricians and psychiatrists believe that undesirable personality changes may be related to inadequate preoperative preparation and sedation. The anesthesiologist finds himself in a dilemma; he does not wish to add to the risks of operation and anesthesia, yet wants to avoid the unpleasant task of anesthetizing apprehensive, struggling, or crying children. The investigation reported herein was begun in order to obtain answers to such problems. Is the incidence of crying (and presumably the danger of psychic trauma) higher in children given only a belladonna drug before anesthesia? Does the employment of sedatives increase the hazards of anesthesia and operation? METHOD OF STUDY