The safety of conscious sedation in peritonsillar abscess drainage.

OBJECTIVE

To demonstrate the safety of conscious sedation in draining peritonsillar abscesses (PTAs).

DESIGN

Children diagnosed as having a PTA in the pediatric emergency department were identified, and their medical records were retrospectively reviewed. Results of the present study were compared with those of a previous report.

SETTING

A tertiary referral children's hospital pediatric emergency department.

PARTICIPANTS

Ninety-one consecutive children initially evaluated in the emergency department and managed for a PTA.

INTERVENTIONS

Peritonsillar abscess incision and drainage with or without sedation. A team of physicians whose activities were documented on a formal conscious-sedation record was present. Patients were monitored for major and minor complications.

OUTCOME MEASURES

The primary outcome measures were major and minor complications. Secondary outcome measures were recurrence of PTA and the need for admission.

RESULTS

There were 62 episodes of conscious sedation for drainage of a PTA. Among the 91 patients, 3 had a recurrence and 24 were admitted after the procedure. A previous study evaluated 30 episodes of conscious sedation for drainage of a PTA. No major complications occurred in either series. Combining the previous data with the present data produced 92 episodes of conscious sedation for drainage of a PTA. The 1-sided upper 95% confidence limit for the rate of major complications is 3.2%.

CONCLUSION

Our series, when combined with previously published data, demonstrates that conscious sedation can be safely used when draining a PTA in pediatric patients.