Perioperative Factors Associated with Initial 24-Hour Oral Intake Following Tonsillectomy in Children for OSA

Saturday, October 11, 2025

10:00 AM - 10:06 AM EDT

Location: 233-234

Disclosure(s):

Michael G. Nicolette, MS, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Decreased oral intake and dehydration are two common adverse events after tonsillectomy in children. Throat pain, swelling, anxiety, nausea, and anesthetic choice have been implicated in decreased oral intake in the 24 hours post-tonsillectomy. As oral intake is an indicator of hydration, nausea, and pain control, this study evaluated whether perioperative factors affected oral intake immediately after surgery and determined whether this correlates with dehydration in the 4-week post-operative healing period.

Methods: A retrospective cohort study was conducted by reviewing records of 1,200 patients between July 2016 and December 2021 at a tertiary care center. Patients were excluded if they were 19 years or older, were not admitted to the hospital post-operatively, or did not have a diagnosis of SDB (sleep disordered breathing) or OSA (obstructive sleep apnea). Demographics, time under anesthesia, operative time, tonsillectomy instrument, presence of resident in the case, use of additional pain medication and use of steroids were collected. Primary outcomes were 24-hour post-operative oral intake and ED visits for dehydration within 4 weeks post-operatively.

Results: 358 patients were included. Older age (p <.001), higher BMI, (p <.001), less time under anesthesia (p=0.009), no resident assistance (p=008), and use of a coblator (p=0.001) were all associated with higher oral intake in the initial 24-hour post-operative period. Factors that did not impact oral intake included gender, AHI (apnea-hypopnea index), use of additional pain medication, operative time, or concurrent performance of myringotomy or adenoidectomy. 24-hour oral intake was not found to correlate with incidence of post-operative dehydration in the 4-week post-operative period.

Conclusions: This study suggests age, BMI, surgical technique / device used, presence of resident in the case, and time under anesthesia rather than operative time were associated with the initial 24-hour post-operative oral intake. These factors might impact post-operative pain and nausea in this population and can be modified to improve immediate recovery.

Presenting Author(s)

Michael G. Nicolette, MS, BA

Medical Student
Cooper Medical School of Rowan University
Cedar Grove, NJ, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Kathy Zhang, MD

Resident
Cooper University Hospital
Philadelphia, Pennsylvania, United States

Disclosure information not submitted.
YK

Yekaterina Koshkareva, MD

Director of General Otolaryngology
Cooper University Health Care
Huntingdon Valley , Pennsylvania, United States

Disclosure information not submitted.
LD

Lucia Diaz Garcia, MD

Director of Laryngology and Upper Airway Surgery Director of Voice and Swallow Clinic
Cooper University Health Care
Camden, NJ, United States

Disclosure information not submitted.
NK

Nadeem Kolia, MD

Director, Rhinology and Endoscopic Skull Base Surgery
Cooper University Health Care, United States

Disclosure information not submitted.

Senior Author(s)

DS

Donald H. Solomon, MD

Director of Pediatric Otolaryngology
Cooper Health System
Camden, NJ, United States

Disclosure information not submitted.