Ambulatory Tympanomastoid Surgery in Children

Abstract

Objective: To identify clinical factors associated with postoperative nausea and vomiting (PONV) and failure to discharge from the hospital on the day of surgery in children undergoing tympanomastoid surgery.Design: Records of 144 children undergoing 152 tympanomastoid surgical procedures from July 1, 2001, through June 30, 2002, were retrospectively reviewed and the data analyzed.Setting: A tertiary care university-affiliated hospital. Results:The mean±SD age of the cases was 11±3.7 years. Sixty-eight cases (45%) were middle ear procedures, while 84 cases (55%) were mastoid procedures. Forty-three cases (28%) were discharged home from the postanesthesia care unit (PACU), 55 cases (36%) were discharged on the day of surgery, and 142 cases (92%) were discharged home from the day surgery unit (DSU) within 23 hours after surgery. Patients who underwent mastoid procedures were more likely to require intravenous (IV) morphine sulfate

Adult ambulatory otologic surgery: Unplanned revisits and complications

“…Properly selected patients for outpatient otologic surgery has also been paramount. Factors previously described as associated with high risk of postoperative complications leading to unplanned admission include comorbid condition of asthma, high postoperative pain level, length of surgery >2 hours, type of surgery (tympanomastoidectomy with ossicular reconstruction), and history of postoperative nausea and vomiting or motion sickness . By carefully choosing patients who are appropriate for outpatient versus inpatient care, rates of unplanned visits and admission can potentially be minimized.…”

Cochlear Implants as a Paediatric Day Surgery Service

“…The most relevant perhaps is postoperative nausea and vomiting (PONV), as this is common after ear surgery (Figure 3). Factors associated with PONV are presence of cholesteatoma, high pain scores, and the requirement of morphine immediately postoperatively (Hasan et al, 2004). If adequate support is provided, and patients are carefully selected, however, both parent and patient satisfaction is high.…”

Should pediatric tympanomastoidectomy and cochlear implantation routinely Be performed as outpatient surgery?

“…All patients were discharged on the same day as surgery after ensuring adequate oral intake and pain control . Hasan et al retrospectively reviewed the records of 144 children undergoing 152 consecutive tympanomastoid surgeries . Sixty‐four percent of patients were discharged on the day of surgery, and 92% were discharged within 23 hours after surgery .…”

“…Hasan et al retrospectively reviewed the records of 144 children undergoing 152 consecutive tympanomastoid surgeries . Sixty‐four percent of patients were discharged on the day of surgery, and 92% were discharged within 23 hours after surgery . Rowlands et al reviewed 35 pediatric patients undergoing mastoid surgery in a combined retrospective and prospective fashion .…”