Anesthetic complications of tympanostomy tube placement in children.
OBJECTIVE
To determine the incidence of perioperative anesthesia complications during bilateral myringotomy with tympanostomy tube placement (BMTT).


METHODS
Tertiary care children's hospital where otolaryngology attending physicians and residents performed surgical procedures. Anesthesia providers included pediatric anesthesiologists, residents, nurse anesthetists, and students.


METHODS
Medical record review was performed for a consecutive series of 3198 children undergoing BMTT (1000 prospectively, 2198 retrospectively). For the prospectively studied patients, major adverse events, which included laryngospasm and stridor, and minor adverse events, including upper airway obstruction, prolonged recovery, emesis, and persistent postprocedural agitation, were noted. Also recorded were the patient's American Society of Anesthesiologists (ASA) physical class status, age, concurrent medical conditions, and type of anesthesia provider.


RESULTS
Fewer than 9% of prospectively studied pediatric patients experienced a minor adverse event, whereas a major event occurred in 1.9%. Eighty-one percent of the events experienced were attributable to agitation or prolonged recovery. Neither ASA status (P =.38), age (P =.15), nor type of anesthesia provider (P =.06) were significantly related to the occurrence of an adverse event. However, a child with an acute or chronic illness has 2.78 times the odds of experiencing an adverse event compared with a child with no illness (P<.001).


CONCLUSIONS
Anesthesia administered for placement of tympanostomy tubes by physicians who specialize in the care of children in a tertiary care children's hospital is safe. The most significant predictor of a minor anesthetic event during BMTT is the presence of a preexisting medical condition or concurrent acute illness.
Hoffmann
Karen K
KK
Department of Otolaryngology, Eastern Virginia Medical School, Norfolk, VA, USA. derkaycs@chkd.com
Thompson
G Kevin
GK
Burke
Bonnie L
BL
Derkay
Craig S
CS
D000208:Acute Disease; D000758:Anesthesia / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D006801:Humans; D007223:Infant; D008876:Middle Ear Ventilation / Q000009:adverse effects*; D010033:Otitis Media / Q000601:surgery*; D019990:Perioperative Care / Q000009:adverse effects*; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome