Development and implementation of new clinical research program in a rural hospital for children undergoing myringotomies or tonsillectomies and adenoidectomies

Abstract

Background & Objective: Pediatric sub-specialty procedures are usually performed in large hospitals by specialists. We aimed to develop a protocol in pediatric patients undergoing bilateral myringotomies (BMT) or tonsillectomies and/or adenoidectomies (T&A) in a rural community hospital.
Methodology: An IRB-approved, prospective study was performed at Lexington Medical Center to examine the
safety (S), emergence (E), and efficacy (E) (SEE) of an anesthetic protocol in patients under 7 y of age undergoing
BMT or T&A. A non-specialist anesthesiology-based team performed the protocol related to SEE.
Results: Out of 60 patients enrolled in the study, 4 (6.6%) desaturated (lowest SpO2 87%), and 6 (10%) had poor
quality of emergence from anesthesia. The mean times for induction, emergence, and surgery for BMT were 4.8 ± 1.3, 4.2 ± 2.2, and 3.9 ± 1.0 min respectively. The mean times for induction-intubation, emergence-extubation, and surgery for T&A were 9.0 ± 2.9, 12.1 ± 6.8, and 14.6 ± 5.8 min respectively.
Conclusion: The development of a clinical research program and study protocol was achieved for pediatric ENT
procedures at a rural hospital. We found that Lexington Medical Center had a low incidence of desaturation, good quality of emergence from anesthesia, and efficacy.
Key words: BMT: bilateral myringotomies; Desaturation; Emergence; Protocol; Pediatric;
Citation: Bryan YF, Wong K, Johnson KN, Choi JA, Harris H, Galla J, Chapman B. Development and implementation of the new clinical research program in a rural hospital for children undergoing myringotomies or tonsillectomies and adenoidectomies. Anaesth. pain intensive care 2023;27(3):315−324.
DOI: 10.35975/apic.v27i3.1501
Received: May 17, 2021; Reviewed: August 30, 2021; Accepted: May 10, 2023