‘Group and save’ for paediatric tonsillectomy: is it required routinely?

Abstract

Objectives: The aims of this study were: (1) to establish current UK practice with respect to ‘group and save’ of serum for paediatric tonsillectomy; and (2) to determine the need to group and save serum prior to routine paediatric tonsillectomy.Methods: Members of the British Association of Otorhinolaryngologists – Head and Neck Surgeons were surveyed by e-mail. A prospective study (November 1999 to August 2002) of all children undergoing tonsillectomy or adenotonsillectomy was undertaken. Outcome measures included reactionary and secondary post-tonsillectomy haemorrhage rates, blood transfusion requirements and ‘return to theatre’ rates.Results: We surveyed 464 association members. The response rate was 52 per cent (n=242). Twenty-five respondents (10.3 per cent) indicated that they undertook group and save prior to tonsillectomy or adenotonsillectomy in children. Two hundred and seventeen (89.7 per cent) indicated that they did not. Of those who did group and save for children, 20 respondents (80 per cent) did so routinely. The remaining five respondents (20 per cent) did so only for children weighing less than 15 kg (n=4) or less than 10 kg (n=1). During the study period, 325 children underwent tonsillectomy or adenotonsillectomy. The reactionary haemorrhage rate was 0.6 per cent (n=2) and the secondary haemorrhage rate 5.5 per cent (n=18). The two cases of reactionary haemorrhage were returned to theatre immediately for control of haemostasis. All secondary haemorrhages were managed conservatively. No child required blood transfusion during the study period.Conclusion: Routine group and save of serum for children undergoing elective tonsillectomy or adenotonsillectomy seems unnecessary. We recommend that it be undertaken only in special circumstances.