I wanted to get some information on the anesthetic management for an
adenotonsillectomy in a child suffering from PFAPA.
What attentions have in conducting / medication management?
You possibly references that I can point to?
Thank you in advance for your attention, friendliness
Attempt to schedule when well (can be difficult). Continue medications I. E. Steroids or histamine antagonists.
Induction: Treat like they have OSA due to adenopathy and potentially crowded oropharynx, confer with surgeon.
In all children (particularly syndromal kids) I keep things simple. SevofluraneN2o induction /fentanyl/propofol/ETT/paracetamol/ondansetron and good local anaesthesia by surgeon. There is no known link to malignant hyperthermia- and fever is a VERY late sign and should not be the factor that rtigers Rx. So I don't think that TIVA is required.
Post op: simple anslgesics. Oral oxycodone elixir as rescue if needed. Ideally monitor in HDU for 12 hrs if possible (I.E. like OSA).
High risk of re bleed due to scaring- suggest to parent to stay within 1hr of Paeds capable facility for next 2 weeks.
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