4
Key Points
6. Additional
recommendations
for PSG
e clinician should advocate for PSG prior to
tonsillectomy for oSDB in children without any
of the comorbidities listed in KAS5 for whom the
need for tonsillectomy is uncertain or when there is
discordance between the physical examination and
the reported severity of oSDB.
R-B-M
7. Tonsillectomy for
obstructive sleep
apnea (OSA)
Clinicians should recommend tonsillectomy for
children with OSA documented by overnight
polysomnography.
R-B-M
8. Education
regarding
persistent or
recurrent oSDB
Clinicians should counsel patients and caregivers
and explain that oSDB may persist or recur aer
tonsillectomy and may require further management.
R-B-H
9. Perioperative pain
counseling
e clinician should counsel patients and caregivers
regarding the importance of managing post-
tonsillectomy pain as part of the perioperative
education process and should reinforce this
counseling at the time of surgery with reminders
about the need to anticipate, reassess, and
adequately treat pain aer surgery.
R-B-M
Treatment
10. Perioperative
antibiotics
Clinicians should NOT administer or prescribe
perioperative antibiotics to children undergoing
tonsillectomy.
S-A-H
11. Intraoperative
steroids
Clinicians should administer a single, intraoperative
dose of intravenous dexamethasone to children
undergoing tonsillectomy.
S-A-H
12. Inpatient
monitoring for
children aer
tonsillectomy
Clinicians should arrange for overnight, inpatient
monitoring of children aer tonsillectomy if they
are under age three years or have severe OSA
(apnea-hypopnea index of ≥10 obstructive events/
hour, oxygen saturation nadir <80%, or both).
R-B-M
13. Postoperative
ibuprofen and
acetaminophen
Clinicians should recommend ibuprofen,
acetaminophen, or both for pain control aer
tonsillectomy.
S-A-H
Table 2. Summary of Key Action Statements (KAS) (cont'd)
Statement Action Grade
