• Michael S Haupert, Clarina Pascual, Abboy Mohan, Beata Bartecka-Skrzypek, and Maria M Zestos.
• Department of Pediatric Otolaryngology, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, USA. mhaupert@med.wayne.edu
• Arch Otolaryngol. 2004 Sep 1;130(9):1025-8.

ObjectiveTo evaluate the effect of intravenous (i.v.) access in children undergoing bilateral myringotomy with pressure-equalizing tube placement.DesignOne hundred healthy children were enrolled in this randomized controlled study. One group received i.v. access; the other group did not. Anesthesia in both groups was induced through a mask and maintained with oxygen, nitrous oxide, and sevoflurane. Spontaneous ventilation was maintained. All children received fentanyl, 1 microg/kg intramuscularly. Children with i.v. access received 20 mL/kg of lactated Ringer's solution. Parents were telephoned the day after surgery to report on pain and vomiting, as well as their satisfaction with anesthesia.SettingTertiary care children's hospital with all procedures performed by attending pediatric otolaryngologists and otolaryngology residents. Anesthesia was administered by a pediatric anesthesiologist and a trainee.ResultsThe groups were similar in age, weight, and incidence of vomiting. Children with i.v. access spent more time than those without (mean +/- SD minutes) in the operating room (21 +/- 8 vs 17 +/- 7; P =.02), in phase 2 recovery (75 +/- 67 vs 51 +/- 24; P =.02), and in the hospital (119 +/- 67 vs 88 +/- 30; P =.005). These children also required more pain medication (31% vs 2%; P<.001) and had a lower parental satisfaction rate (28% vs 95%; P<.001).ConclusionsIntravenous access in otherwise healthy children undergoing myringotomy provided no added benefit. Children without i.v. access had reduced pain requirement and spent less time in the operating room, in phase 2 recovery, and in the hospital. Parental satisfaction, a clinically relevant outcome, was significantly greater for parents of children without i.v. access.

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