With early discharge after outpatient adenotonsillectomy,
postoperative care after discharge is
necessarily the responsibility of the parents. Therefore,
the attitudes and capabilities of the parents
should be considered in selecting patients for
same-day discharge. In addition, the patients
should have no other significant medical problems,
and the family should have ready access to medical
facilities.
We have no information on the incidence of
complications after discharge. Since the frequency
of primary hemorrhage decreased steadily following
surgery, we assume that such complications
were rare.
Our findings suggest that adenoidectomy can
be safely done as an outpatient procedure. Before a
same-day discharge program is instituted for adenotonsillectomy,
active observation should be implemented
and monitored for a trial period to
determine whether these changes in postoperative
care significantly reduce the rate of hemorrhage
after 6 hours following surgery. If the rate were
reduced, adenotonsillectomy could be done as an
outpatient procedure in children who live within
25 km of the hospital, who are observed for at
least 6 hours after surgery and who, during the
observation period, have good oral intake, a temperature
of 38.5°C or less and no airway distress.