The safety of conscious sedation in peritonsillar abscess drainage

Objective: To demonstrate the safety of conscious sedation in draining peritonsillar abscesses (PTAs). Design: Children diagnosed as having a PTA in the pediatric emergency department were identified, and their medical records were retrospectively reviewed. Results of the present study were compared with those of a previous report. Setting: A tertiary referral children's hospital pediatric emergency department. Participants: Ninety-one consecutive children initially evaluated in the emergency department and managed for a PTA. Interventions: Peritonsillar abscess incision and drainage with or without sedation. A team of physicians whose activities were documented on a formal conscious-sedation record was present. Patients were monitored for major and minor complications. Outcome Measures: The primary outcome measures were major and minor complications. Secondary outcome measures were recurrence of PTA and the need for admission. Results: There were 62 episodes of conscious sedation for drainage of a PTA. Among the 91 patients, 3 had a recurrence and 24 were admitted after the procedure. A previous study evaluated 30 episodes of conscious sedation for drainage of a PTA. No major complications occurred in either series. Combining the previous data with the present data produced 92 episodes of conscious sedation for drainage of a PTA. The 1-sided upper 95% confidence limit for the rate of major complications is 3.2%. Conclusion: Our series, when combined with previously published data, demonstrates that conscious sedation can be safely used when draining a PTA in pediatric patients.