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- Title
Effects of the Valsalva maneuver on intraoperative bleeding during tonsillectomy.
- Authors
ÇALIM, Ömer Faruk
- Abstract
Objective: We investigated whether the Valsalva maneuver helps determine more bleeding points after adequate hemostasis during tonsillectomy. Material and methods: This is a prospective research of consecutive patients who undergone tonsillectomy performed at a tertiary medical center. The collected data included patient identity, age, gender, method of operation, and hemorrhage (if any). Immediately after completing the surgery, hemostasis was performed by an anesthesiologist using the Valsalva maneuver to identify bleeding points. Intraoperative and postoperative hemorrhage, as well as the treatment applied, were recorded. Results: 120 patients underwent tonsillectomy during the period (53 males and 67 females). Tonsillectomy was performed using cold dissection in 59 patients (26 males and 33 femaObjective: We investigated whether the Valsalva maneuver helps determine more bleeding points after adequate hemostasis during tonsillectomy. Material and methods: This is a prospective research of consecutive patients who undergone tonsillectomy performed at a tertiary medical center. The collected data included patient identity, age, gender, method of operation, and hemorrhage (if any). Immediately after completing the surgery, hemostasis was performed by an anesthesiologist using the Valsalva maneuver to identify bleeding points. Intraoperative and postoperative hemorrhage, as well as the treatment applied, were recorded. Results: 120 patients underwent tonsillectomy during the period (53 males and 67 females). Tonsillectomy was performed using cold dissection in 59 patients (26 males and 33 females) and bipolar diathermy in 61 patients (34 females and 27 males). The differences in intraoperative hemorrhage following Valsalva were significantly higher in the cold dissection group than in the hot (bipolar) group (p = 0.044). Tonsillectomy using bipolar cautery has a statistically significantly higher postoperative hemorrhage rate over using cold dissection (p < 0.05). Conclusion: The Valsalva maneuver is useful for identifying subtle bleeding vessels in tonsillectomy wound bed. We suggest applying the procedure for final verification of hemostasis before ending the surgery.
- Subjects
VALSALVA'S maneuver; HEMORRHAGE; TONSILLECTOMY
- Publication
Bezmialem Science, 2018, Vol 6, Issue 4, p1
- ISSN
2148-2373
- Publication type
Article
- DOI
10.14235/bs.2018.2299