title: Parental satisfaction with anesthesia without intravenous access for myringotomy.
abstract: OBJECTIVE
  To evaluate the effect of intravenous (i.v.) access in children undergoing bilateral myringotomy with pressure-equalizing tube placement.
  
  
  METHODS
  One hundred healthy children were enrolled in this randomized controlled study. One group received i.v. access; the other group did not. Anesthesia in both groups was induced through a mask and maintained with oxygen, nitrous oxide, and sevoflurane. Spontaneous ventilation was maintained. All children received fentanyl, 1 microg/kg intramuscularly. Children with i.v. access received 20 mL/kg of lactated Ringer's solution. Parents were telephoned the day after surgery to report on pain and vomiting, as well as their satisfaction with anesthesia.
  
  
  METHODS
  Tertiary care children's hospital with all procedures performed by attending pediatric otolaryngologists and otolaryngology residents. Anesthesia was administered by a pediatric anesthesiologist and a trainee.
  
  
  RESULTS
  The groups were similar in age, weight, and incidence of vomiting. Children with i.v. access spent more time than those without (mean +/- SD minutes) in the operating room (21 +/- 8 vs 17 +/- 7; P =.02), in phase 2 recovery (75 +/- 67 vs 51 +/- 24; P =.02), and in the hospital (119 +/- 67 vs 88 +/- 30; P =.005). These children also required more pain medication (31% vs 2%; P<.001) and had a lower parental satisfaction rate (28% vs 95%; P<.001).
  
  
  CONCLUSIONS
  Intravenous access in otherwise healthy children undergoing myringotomy provided no added benefit. Children without i.v. access had reduced pain requirement and spent less time in the operating room, in phase 2 recovery, and in the hospital. Parental satisfaction, a clinically relevant outcome, was significantly greater for parents of children without i.v. access.
authors.affiliation: Department of Pediatric Otolaryngology, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, USA. mhaupert@med.wayne.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Haupert
authors.forename: Clarina
authors.initials: C
authors.lastname: Pascual
authors.forename: Abboy
authors.initials: A
authors.lastname: Mohan
authors.forename: Beata
authors.initials: B
authors.lastname: Bartecka-Skrzypek
authors.forename: Maria M
authors.initials: MM
authors.lastname: Zestos
mesh_terms: D000758:Anesthesia / Q000379:methods*; D002406:Catheterization, Peripheral; D002648:Child; D002675:Child, Preschool; D003258:Consumer Behavior; D006801:Humans; D007902:Length of Stay; D008824:Michigan / Q000453:epidemiology; D008876:Middle Ear Ventilation; D010149:Postoperative Pain / Q000453:epidemiology; D010290:Parents; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology