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OHSU Study Shows Minor Pediatric Ear, Nose, Throat Procedures Can Be Done in Outpatient Setting

   Portland, Ore.

Study shows intravenous sedation is safe, effective alternative to general anesthesia for selected procedures

Children requiring minor ear, nose or throat (ENT) surgery can be treated safely and effectively using intravenous (IV) sedation in an outpatient setting, foregoing more costly general anesthesia in the operating room, which may cost four times as much, according to a study conducted by an Oregon Health & Science University School of Medicine investigator. The study will be published in the June issue of the Journal of American Medical Association's Archives of Otolaryngology/Head and Neck Surgery.

Children who require biopsies of the head and neck, ear tube removal or other minor ENT procedures are usually given general anesthesia because the procedures are painful and may cause anxiety.

Henry Milczuk, M.D., assistant professor of otolaryngology/head and neck surgery in the OHSU School of Medicine, and his collegues reviewed the medical records of children who underwent these types of procedures during a three-year period and found those given IV sedation in a hospital-based outpatient setting achieved the same level of comfort as those given general anesthesia in the operating room.

In total, 103 patient records were reviewed. Fifty-four procedures were performed using IV sedation in a hospital outpatient clinic, and 49 were performed using general anesthesia in the operating room, with the most common procedure being ear tube removal. Milczuk and collegues found the outcomes for the IV sedation group and the general anesthesia group were the same, with any complications being minor and occurring at similar rates.

"This study demonstrates that brief, invasive pediatric ENT procedures can be done safely and effectively in a hospital-based outpatient clinic when the IV sedation is administered and monitored by a pediatric sedation team," said Milczuk, also a pediatric otolaryngologist in OHSU Doernbecher Children's Hospital. "Although our economic analysis has limitations, we also found that hospital charges, on average, were significantly higher for general anesthesia than for IV sedation. As much as four times higher in some cases."

The Department of Otolaryngology/Head and Neck Surgery at OHSU ranks sixth in the nation among otolaryngology departments competing for National Institutes of Health research dollars for fiscal year 2002.


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