Related Experiment Videos
Tracheal extubation practices following adenotonsillectomy in children: effects on operating room efficiency between
Hiromi Kako1,2, Marco Corridore1,2, Sarah Seo3
1Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Tracheal extubation in the postanesthesia care unit (PACU) after pediatric adenotonsillectomy is more efficient than in the operating room. This approach saves valuable operating room time and resources, improving overall hospital efficiency.
Area of Science:
- Pediatric Anesthesiology
- Surgical Operations Management
Background:
- Adenotonsillectomy is a common pediatric surgical procedure.
- Optimizing operating room efficiency and patient safety is crucial.
- Investigating tracheal extubation strategies is key to improving care.
Purpose of the Study:
- To compare the efficiency of tracheal extubation in the operating room versus the postanesthesia care unit (PACU) for pediatric adenotonsillectomy.
- To determine the impact on operating room time and resource utilization.
Main Methods:
- Retrospective chart review of pediatric patients undergoing adenotonsillectomy at two tertiary care children's hospitals.
- Comparison of tracheal extubation performed in the operating room versus in the PACU.
- Inclusion criteria: patients ≤12 years; exclusion: significant cardiopulmonary disease or ICU recovery.
Main Results:
- The study included 672 patients from hospital 1 and 700 from hospital 2.
- Operating room time was 17 minutes shorter when extubation occurred in the operating room.
- Postanesthesia care unit (PACU) times were 26 minutes shorter when extubation occurred in the operating room.
Conclusions:
- Tracheal extubation in the PACU is an efficient use of operating room time and resources.
- This practice can lead to significant time savings in the operating room.
- Further research may explore patient outcomes associated with different extubation sites.
Background:
Adenotonsillectomy is one of the most commonly performed operative procedures in children. It is imperative to find the most efficient and cost-effective methods of practice to facilitate operating room management while maintaining patient safety. We investigated the efficiency of two different approaches of tracheal extubation in pediatric patients following adenotonsillectomy at two tertiary care pediatric hospitals with large surgical volumes. The primary aim of the study was to determine the difference in the operating room time according to the institutional practice of tracheal extubation in the postanesthesia care unit (PACU) as compared to the operating room.
Methods:
After obtaining IRB approval, a retrospective chart review was performed over a 12-month period at two large, tertiary care children's hospitals including the first hospital, where patients undergo tracheal extubation in the operating room after completion of the surgical procedure and a second hospital, where patients are brought directly to the PACU and undergo tracheal extubation in the PACU by nurses, with immediate availability of the pediatric anesthesiology faculty. Patients ≤12 years of age undergoing adenotonsillectomy were eligible for inclusion in the study. Patients with significant cardiopulmonary disease or scheduled for recovery in the critical care unit were excluded. Patient demographics, total time in the operating room, surgical time, total time in the PACU, and, when applicable, time until tracheal extubation, were noted.
Results:
The study cohort included 672 patients from the first hospital and 700 patients from the second hospital. Average operating room time was 17 min shorter at the first hospital than at the other, with most of the difference due to a reduction in the time between surgery end and transport from the operating room. PACU times were also 26 min shorter at the first hospital than at the second children's hospital.
Conclusion:
Tracheal extubation in the PACU is an efficient use of operating room time and resources.