Factors Affecting Blood Loss during Pediatric Tonsillectomy

Objective 1) Know the factors that can affect the amount of blood loss or the change of the hemoglobin or hematocrit level after adenotonsillectomy in children. 2) Find any quantitative correlations between factors and bleeding parameters. Method From 172 child patients receiving adenotonsillectomy, CBC was measured before and after surgery, and then hemoglobin and hematocrit loss percent was calculated respectively. We selected some factors that can affect operative bleeding parameters. Data were analyzed to find any correlation between the factors and bleeding parameters. Results Data were statistically analyzed with two‐tailed Spearman’s rho correlation test and multiple linear regression. Patient body weight factor correlated significantly with hemoglobin ( P =. 018) or hematocrit loss percent ( P =. 036), but not with estimated bleeding amount. Regression equation was [Hemoglobin loss percent = 7.172 ‐ 0.096x (body weight)( P =. 015)] and [hematocrit loss percent = 6.267 ‐ 0.086x (body weight) ( P =. 029)]. Other factors such as surgery‐indicated main symptom, technique, application of adenoid packing, subjective bleeding, and adhesion severity did not correlate with any operative bleeding parameters. Conclusion We can estimate the usual reduction amount of the postoperative hemoglobin (hematocrit) level in children receiving adenotonsillectomy. Amount of reduction of hemoglobin (hematocrit) is larger when the child’s body weight is lower, though the absolute bleeding amount is not affected by body weight. The surgeon should be more careful when performing adenotonsillectomy on a lower weight child.