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Overmedication in Outpatient Tonsillectomy-Reply

Mark E. Gerber, MD; Elena Adler, MD; Charles M. Myer III, MD
Arch Otolaryngol Head Neck Surg. 1997;123(1):117. doi:10.1001/archotol.1997.01900010126025.
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We would like to thank Gaskill for his comments on "Selected Risk Factors in Pediatric Adenotonsillectomy," which appeared in the August issue of the Archives,1 and applaud his efforts to raise the issue of anesthetic technique in the care of pediatric adenotonsillectomy patients in the form of this and another letter to the editor.2

The standard anesthetic technique used at Children's Hospital Medical Center, Cincinnati, Ohio, for children undergoing adenotonsillectomy for obstructive sleep apnea includes judicious use of preoperative medication and intraoperative narcotics. Narcotics are not routinely given to children younger than 5 years postoperatively. After re-reviewing the data from the 44 children who developed respiratory compromise by the criteria set forth in our article, anesthetic technique did not appear to play a role. However, in 7 patients, significant obstructive events were recorded within 2 hours of receiving either codeine or promethazine hydrochloride during the initial


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