title: Paediatric day-case otoplasty: local versus general anaesthetic.
abstract: BACKGROUND
  Correction of prominent ears (otoplasty) is routinely done as an elective cosmetic procedure. The operation is typically performed under general anaesthesia, which is favoured in the paediatric population, being considered more 'humane' than local anaesthesia.
  
  
  OBJECTIVE
  Our aims were to demonstrate the feasibility of paediatric otoplasty as a day case procedure and to examine the relative efficacy of general versus local anaesthesia, paying particular attention to post-operative morbidity.
  
  
  METHODS
  Data were gathered retrospectively from case notes, day case surgery pro-formas and dressing clinic notes to compare post-operative morbidity in the two groups. Specific parameters assessed included vomiting, post-operative bleeding, wound dehiscence, necessity of overnight stay and need for revision surgery.
  
  
  RESULTS
  Eighty-five children, underwent a day case otoplasty procedure (age range 4-17 years; mean 7.3). Forty-four received a general anaesthetic, whilst forty-one received percutaneous infiltration of local anaesthetic. Local anaesthetic was well tolerated by the children. No procedure was abandoned due to pain. No disadvantage was demonstrable in either group by performing the operation as a day case procedure. Post-operative vomiting was shown to be a significantly greater problem in the children receiving general anaesthesia (p<0.0001).
  
  
  CONCLUSIONS
  Otoplasty as a day case procedure appears acceptable whether general or local anaesthesia is used. In addition, percutaneous infiltration of local anaesthetic, results in a marked reduction in post-operative vomiting without compromising surgical outcome.
authors.affiliation: Royal Liverpool and Broadgreen University Hospitals, Prescot Road, Liverpool, UK. jeffreylancaster@hotmail.com
authors.forename: J L
authors.initials: JL
authors.lastname: Lancaster
authors.forename: T M
authors.initials: TM
authors.lastname: Jones
authors.forename: A R
authors.initials: AR
authors.lastname: Kay
authors.forename: D D
authors.initials: DD
authors.lastname: McGeorge
mesh_terms: D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D000772:Anesthesia, Local; D002648:Child; D002675:Child, Preschool; D004423:Ear / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies