Patients were selected from those admitted in ENT unit of Birjand Vliasr hospital for tonsillectomy and adeno-tonsillectomy. All patients were examined by an ENT specialist before surgery and then referred to anesthesia clinic for pre-operation evaluation.
The conditions for participating in the study were explained for all patients or their guardians and a written consent was obtained if they tended to participate. Participants were randomly divided in two experimental and control groups. Patients were hospitalized in ENT one day before operation while their vital signs, history and physical examination were performed by the ENT specialist. In all patients routine pre-operation tests were done including; CBC diff, B&G Rh PT& PTT, nasopharynx and lateral radiographs, and in patients over 40 years ECG and CXR.
The night before surgery patients were NPO for at least 8 hours. In control group serum dextrose water %5 was started as maintenance with a dose of 35 mg/kg body weight in adults and 10 mg/kg body weight in children. In experimental group during the first 24 hours, in addition to serum dextrose water %5, the same dose of ampicillin was used. Patients took ampicillin in IV, 75 mg/kg a dose before surgery and then for 24 hours 1 dose every 6 hours. Next they received 50 mg/kg amoxicillin every 6 hours for a week. After surgery patients took serum until they were able to eat.
In the recovery patients were examined by a trained but unaware nurse (who didn’t know which group had received antibiotics and which had not) every hour for 4 hours, then every 3 hours in two sessions (up to 10 hours after surgery) and after 24 hours. Bleeding, nausea and vomiting, the start time of drinking liquids, speak status, pain, oral temperature and wound healing were all considered and data was recorded in a questionnaire.
Patients were discharged from the hospital after 24 hours and were recommended to refer in any case of complications and intense pain. 7 days after the surgery patients were visited again for evaluation of their improvement and data was recorded. Both groups received washing with cold NS (normal saline) and the same cold liquid diet.