Tonsillectomy under Local Anesthesia: Is It Safe, Feasible and Practicable? Experience at Tertiary Care Hospital

INTRODUCTION anesthesia. Present study was done to determine the Tonsillectomy is the most frequently performed complications after tonsillectomy under local ENT surgical procedure throughout the world. anesthesia. The first known removal of tonsil dates back to the first century AD when Cornelius celsius in Roma 1 SUBJECTS AND METHODS used his finger to do it. Dissection tonsillectomy st first described by Edwin Pynchon in 1890. This cross sectional study was conducted from 1 Tonsillectomy is not an easy operation and must be January, 2012 and completed in February 2013 at viewed with respect due to its potentially fatal ENT department BVH, Bahawalpur. A total of 80 outcome which is related to hemorrhage and use of consecutive patients who fulfilled the inclusion 1 general anesthesia. criteria underwent tonsillectomy under local There are many methods of performing anesthesia, were included in this study. tonsillectomy like Guillotine, dissection, Inclusion criteria: Adult patients of chronic electrodiathermy, cryosurgery, coablation, laser & tonsillitis between 16-30 years age of both sexes with harmonic scalpel. Mostly, the operation is good and adequate mouth opening. performed under general anesthesia with Exclusion criteria: Indication of tonsillectomy like endotracheal intubation and laryngeal pack quinsy, tonsillar growth and sleep apnea syndrome around it. Tonsillectomy is reported in literature etc in any age of any sex. Sleep apnea syndrome with underlocal anesthesia although a few studies are history of pan/chalia chewing for years, patients 3,4 having trismus and inadequate mouth opening. present in the world. Tonsillectomy under local Surgery was performed by the surgery having more anesthesia is safe, feasible and effective than ten years of experience in the specialty. All the alternative to general anesthesia in healthy patients were admitted in ENT department BVH, cooperative adult patients. Per-operative blood Bahawalpur one day prior to the surgery. A detailed loss is also less (40-50 ml) as compared to about 2 history specially duration of sore throat, number of under general anesthesia. attacks of acute tonsillitis per year, associated fever As yet no study is available in Pakistan to evaluate and odynophagia was taken. Thorough ENT examination specially signs of chronic tonsillitis like dusky pillars, retention cyst and palpable non tender jugulo-digastric lymph nodes were done. Routine investigations especially blood complete examination with ESR and platelet count, urine complete examination. Prothrombin time, activated TONSILLECTOMY UNDER LOCAL ANESTHESIA: IS IT SAFE, FEASIBLE AND PRACTICABLE? EXPERIENCE AT TERTIARY CARE HOSPITAL