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Tonsillectomy and Adenoidectomy: Perioperative Care Clinical Pathway

Pathway Background and Objectives

Tonsillectomy and adenoidectomy is a common procedure with greater than 500,000 performed annually in the United States. However, there is variability in peri-operative and post-operative care for these patients. This can lead to confusion and dissatisfaction for patients, families, and providers.  Additionally, guidelines were updated in 2011 in regards to peri-operative steroid use and post-operative antibiotic use. Based on these changes and through standardization of our workflows, we have applied these recommendations to provide a consistent approach to treatment of children undergoing tonsillectomy and adenoidectomy.

The specific objectives of this pathway are to:

  • Standardize the management of Tonsillectomy and Adenoidectomy patients based on severity of their obstructive symptoms
  • Standardize the use of medications with a goal of no perioperative antibiotics and one dose of IV steroids in the operating room

Algorithm

Download Tonsillectomy & Adenoidectomy: Perioperative Care Algorithm

Quality Metrics

  • Percentage of patients with NO intra-op antibiotic use
  • Percentage of patients receiving single dose steroid intra-operatively
  • Length of stay
  • Percentage of patients with return ED visits (up to 14 days post-operatively) for pain, hemorrhage, or dehydration
  • Number of admissions/observations for post-operative bleeds
  • Number of patients returning to the OR for bleeds

Educational Module

Download Tonsillectomy & Adenoidectomy: Perioperative Care Educational Module

Key References

Pathway Contacts

Christopher Grindle, MD

Disclaimer

The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case.

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