Outpatient Tympanomastoidectomy

Abstract

A history of PONV or motion sickness is predictive of PONV and length of hospital stay. Routine planning for a 23-hour overnight observation stay seems warranted for all patients undergoing tympanomastoidectomy, despite severity of disease.

Controlled hypotension for middle ear surgery: a comparison between remifentanil and magnesium sulphate

“…and study drugs (remifentanil and magnesium sulphate) were administered using an Orchestra w infusion pump system (Fresenius vial, Brezins, France) in both groups. Using target-controlled infusions with Minto model, patients in Group R were administered with remifentanil infusion 4 ng ml 21 during induction of anaesthesia and then the effect-site concentration of remifentanil was titrated about 3-4 ng ml 21 during the operation. Group M patients received an i.v.…”

“…Group M patients received an i.v. bolus injection of magnesium sulphate 50 mg kg 21 in saline (total 100 ml) over 10 min during the induction of anaesthesia, and then 15 mg kg 21 h 21 by continuous infusion until the end of the operation. This dosage was based on a previous investigation on induced hypotension.…”

“…This dosage was based on a previous investigation on induced hypotension. 8 After loss of eyelid reflex, patients were ventilated with 2.5 MAC sevoflurane, and rocuronium 0.6 mg kg 21 was given to facilitate tracheal intubation. Anaesthesia was maintained with sevoflurane targeting BIS (bispectral index score) between 40 and 60 and mean arterial pressure (MAP) between 60 and 70 mm Hg during the operation.…”

“…20 In a previous study, middle ear surgery was performed as a day-case procedure, and only one-third of patients could be discharged on the day of surgery, primarily because of PONV. 21 Accordingly, because PONV can be a barrier to early recovery and discharge, the use of intraoperative magnesium sulphate may be beneficial in patients undergoing middle ear surgery. In addition to PONV, patients in the magnesium sulphate group tended to experience less postoperative shivering, which concurs with previous investigations on the subject.…”

Day-Case Management of Chronic Suppurative Otitis Media with Cholesteatoma with Canal Wall down Technique Surgery: Long-Term Follow-up

“… 8 The type of surgical procedure is one variable that can significantly influence the nature of the postoperative course and the rate of postoperative complications; complex procedures, such as tympanomastoid surgery, may have a different postoperative course compared to other surgical procedures. 9 …”