Usefulness of bleeding Profile in Adenotonsillectomy

Abstract

Introduction: Infectious and inflammatory diseases involving the pharynx, tonsils, and adenoids account for a significant proportion of childhood illnesses and pediatric health care expenditures. Preoperative assessment in patients undergoing adenotonsillectomy is crucial and may reveal problems that could complicate either surgery or the patient’s postoperative course. It is crucial to detect the existence of any coagulation abnormalities. routine evaluation of coagulation parameters before surgery in patients undergoing. adenotonsillectomy is controversial.
Aim of study: asseses the need for coagulation profile prior to adenotonsillectomy
Method: This study is prospective, consisted of 321 children complaining of adenotonsillar problem. Age, sex, history, physical examination, hemoglobin (Hb %) and bleeding profile in form of prothrombin time, partial thromboplastin time, international normalized ratio was done for all patients. Patients with risk factor for bleeding, abnormal bleeding profile and further work reveals clotting abnormality were excluded from study.
Results: Two patients of normal investigation developed secondary hemorrhage, which is due to infection and treated conservatively. Two of prolonged bleeding profile developed primary bleeding readmitted to theater one of them from adenoid remnant, and one from slip ligature.
Discussion: Bleeding problems in surgical patients are not uncommon and may occur for a variety of reasons if a bleeding disorder is suspected, a careful clinical history and examination make important contributions in reaching a diagnosis.in our study we find no significant intraoperative or postoperative bleeding occurs due to prolong bleeding profile so relevance of bleeding profile before adenotonsiilectomy is questionable.
Conclusion: The routine preoperative bleeding profile is not recommended in every patient undergo adenotonsillectomy operation unless past medical, family history or physical examination suggest bleeding disorders.