Effect of carboxyhemoglobin on postoperative complications and pain in pediatric tonsillectomy patients

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dc.authoridAkbay, Ercan/0000-0003-0640-1246
dc.contributor.authorKoyuncu, Onur
dc.contributor.authorTurhanoglu, Selim
dc.contributor.authorTuzcu, Kasim
dc.contributor.authorKarcioglu, Murat
dc.contributor.authorDavarci, Isil
dc.contributor.authorAkbay, Ercan
dc.contributor.authorCevik, Cengiz
dc.date.accessioned2024-09-18T20:06:30Z
dc.date.available2024-09-18T20:06:30Z
dc.date.issued2015
dc.departmentHatay Mustafa Kemal Üniversitesien_US
dc.description.abstractBackground: Carbon monoxide (CO) is a product of burning solid fuel in stoves and smoking. Exposure to CO may provoke postoperative complications. Furthermore, there appears to be an association between COHb concentrations and pain. We thus tested the primary hypothesis that children with high preoperative carboxyhemoglobin (COHb) concentrations have more postoperative complications and pain after tonsillectomies, and secondarily that high-COHb concentrations are associated with more pain and analgesic use. Methods: 100 children scheduled for elective tonsillectomy were divided into low and high carbon monoxide (CO) exposure groups:COHb 3 or 4gdl(-1). We considered a composite of complications during the 7days after surgery which included bronchospasm, laryngospasm, persistent coughing, desaturation, re-intubation, hypotension, postoperative bleeding, and reoperation. Pain was evaluated with Wong-Baker Faces pain scales, and supplemental tramadol use recorded for four postoperative hours. Results: There were 36 patients in the low-exposure group COHb [1.81.2gdl(-1)], and 64 patients were in the high-exposure group [6.4 +/- 2.1gdl(-1)]. Indoor coal-burning stoves were reported more often by families of the high- than low-COHb children (89% vs 72%, P<0.001). Second-hand cigarette smoke exposure was reported by 54% of the families with children with high COHb, but only by 24% of the families of children with low COHb. Composite complications were more common in patients with high COHb [47% vs 14%, P=0.0001, OR:7.4 (95%Cl, lower=2.5-upper=21.7)], with most occurring in the postanesthesia care unit. Pain scores in postanesthesia care unit and one hour after surgery were statistically significantly lower in the low-exposure group [respectively, P=0.020 (95%CI, lower=-1.21-upper=-0.80), P=0.026 (95%CI, lower=-0.03-upper=0.70)], and tramadol use increased at 4h (3.5 (interquartile range: 0-8) vs 6 (5-9) mg, P=0.012) and 24h (3.5 (0-8) vs 6 (5-9) mg, P=0.008). Conclusion: High preoperative COHb concentrations are associated with increased postoperative complications and pain.en_US
dc.identifier.doi10.1111/pan.12531
dc.identifier.endpage252en_US
dc.identifier.issn1155-5645
dc.identifier.issn1460-9592
dc.identifier.issue3en_US
dc.identifier.pmid25251189en_US
dc.identifier.scopus2-s2.0-84922636202en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage247en_US
dc.identifier.urihttps://doi.org/10.1111/pan.12531
dc.identifier.urihttps://hdl.handle.net/20.500.12483/8553
dc.identifier.volume25en_US
dc.identifier.wosWOS:000348865800005en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofPediatric Anesthesiaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectcarbon monoxideen_US
dc.subjectcarboxyhemoglobinen_US
dc.subjecttonsillectomyen_US
dc.subjectchilden_US
dc.subjectpostoperative complicationsen_US
dc.subjectpainen_US
dc.titleEffect of carboxyhemoglobin on postoperative complications and pain in pediatric tonsillectomy patientsen_US
dc.typeArticleen_US

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