Today, there is only one effective way to treat adenoids - adenotomy (removal of adenoids). There are different methods of this operation. Adenotomy differs from painkillers in terms of local anesthesia and anesthesia.
Until recently, there were no very effective agarectomy methods, and adenotomies were performed on all patients without anesthesia. Therefore, as a rule, parents are worried about this issue, based on the fact that their adenoids or their relatives are removed without anesthesia. What kind of anesthesia should be used for such operations?
Currently, there are two types of anesthesia.
To date, the advantages and disadvantages of local anesthesia and general anesthesia are discussed in the literature. Local anesthesia is performed by rubbing or spraying painkillers on the mucous membrane. When it is performed correctly, this method is quite effective, but during the operation, the child is alone and sees everything. Even if the child does not feel the pain, he is afraid and cries when he sees blood. This affects the psychology of some children, and it is impossible to force him to show his throat to the doctor after surgery. Therefore, it is advisable to supplement local anesthesia with intramuscular administration of sedatives.
This method has been used for many years and is quite effective. The main thing is that the child is in himself, but "sedated", which alleviates mental trauma. Proponents of local anesthesia, which is the vast majority of Russian doctors, see the advantages of this method: 1) quick operation; 2) they consider the minimum number of personnel and equipment and very limited costs.
As evidence that emphasizes the advantages of this method, they consider possible internal bleeding in general anesthesia and complications such as nausea and dizziness that can occur after anesthesia. At the same time, according to many authors (I completely share this opinion), mainly K. Keppe, (1996), there are few cases of bleeding in general anesthesia. I think it will be easy for you to choose the operation method based on these pictures and videos.
I agree with the authors who believe that adenotonsillectomy in children should be performed under endotracheal anesthesia. Although it takes a lot of work, time and resources, the application of anesthesia gives great advantages. First of all, it is necessary to remember the psychoemotional trauma that occurred. You need to work on it from the first day you meet the child. In order to protect the child's psyche, in my opinion, patients should not be separated from their parents by excluding the period of operation. In addition, regardless of the use of local anesthesia, children have severe memories of surgery, especially adenotomy. For general anesthesia, endotracheal anesthesia with fluorothano-nitrogen is administered with strong inhalation, created with the use of a muscle relaxant. Endotracheal tubes with inflatable cuffs are used for warning purposes. The operation is performed with the patient lying on his back. The use of an integrated spatula mouthpiece provides ample opportunities for left-handed movement.
I hope that the choice about anesthesia has become a little clearer.
Depending on the instruments used, adenotomy is classical, cold plasma, endoscopic. Regardless of the method, the purpose of the operation is to cut and remove the adenoid tissue from the nasopharyngeal passage. Each method has its own characteristics, which not only specialists, but also parents should know for the right choice.
Now let's study the methods of adenotomy separately. The following will apply to the operation performed under general anesthesia.