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Canadian Journal of Anesthesia, Vol 5, 61-71, Copyright © 1958 by Canadian Anesthesiologists' Society

Anaesthesia for Tonsillectomy and Adenoidectomy in Children

DOUGLAS F. McALPINE M.B., CH.B., D.A.; F.A.C.A., F.F.A.R.C.S.1 and MELVIN W BOWERING M.D1

1 Department of Anaesthesia, Regina General Hospital, Regina, Sask

The children undergoing, and the surgeons performing, tonsillectomy have for too long been denied the safety, comfort and operating conditions made possible by modern anaesthesia. Although this is a minor operation complications are apt to occur, and the cause and prevention of these are discussed. A technique which has proved safe, efficient and free from complications in a personal series of 3,262 cases over the last four years will permit induction and intubation within 60–90 seconds, complete control of anaesthesia for as long as may be required, and recovery of consciousness within 1–2 minutes of the end of the operation.

This technique is based on light premedication, intravenous induction with Thiopentone (25 mg per 10 lb of body weight) and succinylcholine (5 mg. per 10 lb. of body weight) and hyperventilation with oxygen prior to oral intubation. Maintenance is by artificial ventilation with nitrous oxide–oxygen, with or without minimal trichlorethylene, the intermittent administration of succinylcholine (1/4–1/2 induction dose) being used to potentiate anaesthesia, control respiration and provide a quiet, relaxed throat. The endotracheal tube is kept at the side opposite to that on which the surgeon is working, and extubation is carried out in a Trendelenburg or semi-prone position on recovery of consciousness at the conclusion of the operation.

The surgeons appreciate the more rapid induction, better operating conditions and reduction in operative and postoperative complications, and it is felt that the advantages of endotracheal intubation are so apparent that reluctance to intubate can only be caused by inadequate equipment or poor technique. This selection of agents and technique, with or without minor variations, has been found of value in a variety of operations on infants and children.

Note:

Presented at the Annual Meeting, Canadian Anaesthetists' Society, Saskatoon, Sask., June 25, 1957.






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Copyright © 1958 by the Canadian Anesthesiologists' Society.