Is general anesthesia or local anesthesia better for tonsil surgery?

Although common tonsils generally do not require surgical treatment, they can be effectively cured through medication, lifestyle and conditioning. Don’t we know that in many cases, especially when tonsils have developed to a certain extent, surgical treatment is required? Then surgery naturally involves a problem. The biggest problem is anesthesia, that is, choosing local anesthesia or global anesthesia.

The operation is performed under general anesthesia, and the tonsils are removed when the patient enters a deep sleep and loses the sense of pain. Most incisions do not require stitches and can heal naturally. Patients are generally hospitalized for observation for more than 24 hours after surgery. It is generally believed that tonsillectomy will not have any adverse effects on later life.

Pros and cons of surgery

Some parents ask doctors to remove their children's tonsils surgically because their children often suffer from tonsillitis, but doctors generally consider this carefully. Why can’t tonsils be removed casually?

Tonsils are the largest lymphoid tissue in the pharynx. During childhood, it is an active immune organ that contains lymphocytes at various stages of development, such as T cells, B cells, macrophages, etc. Therefore, it not only has humoral immunity, producing various immunoglobulins, but also has certain cellular immunity. The immunoglobulin IgA produced by tonsils has strong immunity, which can inhibit the adhesion of bacteria to the respiratory mucosa, inhibit the growth and spread of bacteria, and also has a neutralizing and inhibitory effect on viruses. IgA can also enhance the function of phagocytes through complement activation. These are most active between the ages of two and five.

From an immune point of view, tonsils should not be removed casually due to their immune effects on the body. Enlarged tonsils in children are a normal physiological phenomenon. If the enlargement does not affect breathing and swallowing and does not cause serious clinical manifestations, they should not be removed. Because resection may affect the local immune response and reduce the body's ability to fight infection. If tonsillitis recurs, interferes with breathing and swallowing, and causes diseases such as rheumatism and nephritis, it should be removed promptly. Generally, tonsillectomy for children should be performed after the age of four, and it is more appropriate to wait two to three weeks after the inflammation subsides. However, if the attacks are too frequent and you cannot wait too long, you may consider having surgery a few days after the attacks subside.

General anesthesia is recommended for tonsillectomy

Disadvantages of tonsillectomy under local anesthesia

1. It is difficult for children to cooperate with doctors in injecting anesthetic drugs into the pharynx

2. For some patients, local anesthesia is difficult to suppress the nausea reflex in the pharynx, which will affect the doctor's intraoperative operation

3. If there is heavy bleeding during surgery, it is dangerous to treat it under local anesthesia

In tonsil surgery, general anesthesia can easily solve three problems that are difficult to solve with local anesthesia.

During the operation, the patient is in a quiet sleeping state, and the doctor calmly performs various operations on the pharynx. The anesthesia machine monitors the patient's vital signs and adjusts the dosage of anesthetics at any time.

After surgery, you may still use a pain pump (an anesthesia device you carry with you) to relieve throat pain during the first few days after surgery. Compared with local anesthesia, the main disadvantage of general anesthesia is its high cost, which is calculated in thousands of yuan. There is indeed some pressure on families in economically underdeveloped areas.