Ventilation tube insertion using topical anaesthesia in children.

Area of Science:

• Pediatric Otolaryngology
• Anesthesiology

Background:

• Topical anesthesia with EMLA cream is a standard procedure for ventilation tube insertion in adults.
• Its efficacy and safety in pediatric patients require specific evaluation.

Purpose of the Study:

• To assess the effectiveness and safety of EMLA cream for topical anesthesia during ventilation tube insertion in children.
• To identify optimal application parameters for successful pediatric procedures.

Main Methods:

• A prospective study involving 103 children (aged 3-12 years) undergoing ventilation tube insertion.
• Application of EMLA cream as a topical anesthetic prior to the procedure.
• Monitoring for procedural success, failure, and any adverse events.

Main Results:

• A high success rate of 93.2% (7 failures out of 103 patients).
• Minor complications occurred in only two patients.
• The technique was well-tolerated when suction was avoided and cream penetration time exceeded two hours.

Conclusions:

• EMLA cream is a safe and effective topical anesthetic for ventilation tube insertion in children.
• Adherence to specific procedural guidelines, including adequate penetration time and avoiding suction, is crucial for optimal outcomes.
• The use of 'T' myringotomy is recommended to minimize intraoperative stress on the tympanic membrane.