Author(s)
Quinn T. Orb, Aida Rezaie, Sheldon Furst, Jeremy Meier, Albert H. Park
Affiliation(s)
1 University Of Utah, 2 University Of Utah
Abstract:
Introduction: There is increasing concern regarding the risks associated with the use of general anesthesia in pediatric patients. Many otolaryngologic procedures performed under general anesthesia can also be performed in clinic. We hypothesize that anxiolytics can aid in performing common otolaryngologic procedures in clinic thus avoiding the need to undergo general anesthesia in the OR. Objectives: To evaluate the patient demographics, outcomes, and costs associated with in-office procedures performed using anxiolytics and compare these results to similar procedures performed in the OR. Methods: We performed a retrospective review of patients undergoing in-office procedures with anxiolytics in our pediatric otolaryngology outpatient clinic between January 2010 and January 2017. Charts were reviewed for age, past medical history, procedure type/duration, and outcome. These results were then compared to a cohort undergoing similar procedures in the OR. Results: A total of thirty-five patients underwent an in-office procedure with an anxiolytic. The success rate was 97% (34/35). Six children (17%) had a known history of chromosomal abnormalities and two children (6%) had autism. The four most common procedures performed were cerumen impaction removal (8), septal cautery (5), ear canal foreign body removal (5), and flexible laryngoscopy (6). The average duration of each clinic visit was seventy minutes. Performing the same procedures under general anesthesia added an additional $520 on average to the total cost. Conclusions: Performing procedures with anxiolytics in a pediatric otolaryngology clinic is safe, expeditious, and cost-effective. Anxiolytics provide an effective alternative to performing pediatric otolaryngologic procedures in the OR under general anesthesia.