Toowoomba Base Hospital, Australia
Title: The effect of intra-operative parecoxib in tonsillectomy and post-operative bleeding at toowoomba hospital
Dr Christopher Jackson is a Principal House Officer in ENT at the Toowoomba Hospital in Queensland where he has been based for two years. He graduated from the University of Queensland in 2015 and holds academic title at this institution with ongoing research within the ENT field.
Tonsillectomy is a common procedure performed by otolaryngologists. There appears to be significant variation in analgesic practices between hospitals and surgeons and some of this variation likely stems from considerations regarding post-operative bleeding risk, particularly with respect to non-steroidal anti-inflammatory drugs (NSAID). Previous studies have demonstrated peri-operative parecoxib administration to be associated with less acute pain than standard treatments. The aim of this study was to determine whether the use of intra-operative selective cyclooxygenase-2 (COX-2) inhibitors was associated with an increase in post-tonsillectomy bleeding (PTB) rates at our institution. Retrospective data were collected from patients at Toowoomba Hospital who underwent tonsillectomy from January 2016 until November 2017. Patient data including demographics, operation type and whether intra-operative Parecoxib was given to the patient was collected. Re-admission rates due to any PTB and return to theatre rates for each group were compiled and analysed. There were 574 patients who underwent tonsillectomy during the 20 months included in this study. 168 patients (29.3%) received a single dose of intravenous Parecoxib intra-operatively. The total re-admission rate for this period was 6.8% (N=39) with a return to theatre rate of 2.3% (N=13). For the patients that did not receive Parecoxib the re-admission rate was 6.2% with a return to theatre rate of 2.2%. For the patients who received Parecoxib the re-admission rate was 9.5% and 2.4% required return to theatre. Comparing those that had Parecoxib and those that did not there was a statistically significant (P<0.05) difference in re-admission rate but not in return to theatre rate.