Intravenous sedation vs general anesthesia for pediatric otolaryngology procedures.
Arch Otolaryngol Head Neck Surg
; 129(6): 637-41, 2003 Jun.
Article
en En
| MEDLINE
| ID: mdl-12810468
ABSTRACT
OBJECTIVE:
To compare efficacy, safety, and hospital charges for common pediatric otolaryngology procedures with the use of intravenous sedation (IVS) vs general anesthesia (GA).DESIGN:
Retrospective chart study.SETTING:
Hospital-based pediatric otolaryngology practice. PATIENTS Patients younger than 18 years who underwent tympanostomy tube removal and/or patch myringoplasty with absorbable gelatin sponge, nasal ciliary biopsy, fine-needle aspiration, or other minor procedures between September 1, 1998, and August 31, 2001.INTERVENTIONS:
Procedures performed in 2 settings outpatient clinic with IVS or operating room with GA. MAIN OUTCOMEMEASURES:
Procedure completion rate, tympanic membrane perforation rate after ear procedures, complications, and hospital charges.RESULTS:
Of 103 procedures, 54 were performed with IVS and 49 with GA. Within the GA group, 32 of 49 patients had additional operations performed and were excluded from analysis of safety and hospital charges. Procedure completion rate was 100% in both groups. The most common procedure was tympanostomy tube removal with patch myringoplasty (IVS, 52 ears; GA, 42 ears). The rate of persistent tympanic membrane perforation was similar between these groups (IVS, 7 [16%] of 45 ears; GA, 5 [15%] of 33; P =.96). All complications were minor and occurred at similar rates (IVS, 10 [19%] of 54 ears; GA, 3 [18%] of 17; P =.94). These events included hypoxia, airway obstruction, and bradycardia, all of which resolved spontaneously or responded to noninvasive interventions such as oxygen or repositioning. Average hospital charges were significantly higher for the GA group (IVS, $356.22; GA, $1516.55; P<.001).CONCLUSION:
Various procedures can be performed safely, effectively, and with decreased hospital charges with the use of IVS administered by a pediatric sedation service.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Procedimientos Quirúrgicos Otorrinolaringológicos
/
Sedación Consciente
/
Anestesia General
Tipo de estudio:
Observational_studies
Límite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Arch Otolaryngol Head Neck Surg
Asunto de la revista:
OTORRINOLARINGOLOGIA
Año:
2003
Tipo del documento:
Article
País de afiliación:
Estados Unidos