Myringotomy for ear tubes - Revision history

Chris.Rishel: Switched drug references to generic names, fixed spelling, linked to related articles.

2024-03-27T17:49:21Z

Switched drug references to generic names, fixed spelling, linked to related articles.

← Older revision		Revision as of 10:49, 27 March 2024
Line 7:		Line 7:
	\| considerations_intraoperative = Laryngospasm		\| considerations_intraoperative = Laryngospasm
	\| considerations_postoperative = Laryngospasm, PONV, emergence delirium		\| considerations_postoperative = Laryngospasm, PONV, emergence delirium
	}}		}}'''Myringotomy for ear tubes''' is a commonly performed procedure in pediatrics. The procedure involves placement of tubes within the middle ear to provide better drainage decreasing the risk of otitis media. Indication for the procedure includes recurrent otitis media episodes of six or more in one year, chronic serous otitis media, eustachian tube dysfunction and hearing loss <ref>{{Cite book\|url=https://www.worldcat.org/oclc/1117874404\|title=Anesthesiologist's manual of surgical procedures\|date=2020\|others=Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu\|isbn=978-1-4698-2916-6\|edition=Sixth edition\|location=Philadelphia\|oclc=1117874404}}</ref>. The procedure begins with an incision of the tympanic membrane. A tympanostomy tube is placed within the incision allowing for equalization of pressure and drainage of fluid in the middle ear<ref>{{Cite journal\|last=Robinson\|first=Hal\|last2=Engelhardt\|first2=Thomas\|date=2017-04-19\|title=Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives\|url=https://www.dovepress.com/ambulatory-anesthetic-care-in-children-undergoing-myringotomy-and-tube-peer-reviewed-fulltext-article-LRA\|journal=Local and Regional Anesthesia\|language=English\|volume=10\|pages=41–49\|doi=10.2147/LRA.S113591\|pmc=PMC5403003\|pmid=28458577}}</ref>.

	Myringotomy is a commonly performed procedure in pediatrics. The procedure involves placement of tubes within the middle ear to provide better drainage decreasing the risk of otitis media. Indication for the procedure includes recurrent otitis media episodes of six or more in one year, chronic serous otitis media, eustachian tube dysfunction and hearing loss <ref>{{Cite book\|url=~~https://www.worldcat.org/oclc/1117874404\|title~~=~~Anesthesiologist's manual of surgical procedures\|date~~=~~2020\|others~~=Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu\|isbn=978-1-4698-2916-6\|edition=Sixth edition\|location=Philadelphia\|oclc=1117874404}}</ref>. The procedure begins with an incision of the tympanic membrane. A tympanostomy tube is placed within the incision allowing for equalization of pressure and drainage of fluid in the middle ear<ref>{{Cite journal\|last=Robinson\|first=Hal\|last2=Engelhardt\|first2=Thomas\|date=2017-04-19\|title=Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives\|url=https://www.dovepress.com/ambulatory-anesthetic-care-in-children-undergoing-myringotomy-and-tube-peer-reviewed-fulltext-article-LRA\|journal=Local and Regional Anesthesia\|language=English\|volume=10\|pages=41–49\|doi=10.2147/LRA.S113591\|pmc=PMC5403003\|pmid=28458577}}</ref>.		==Preoperative management==

	~~== Preoperative management ==~~		===Patient evaluation<!-- Describe the unique and important aspects of preoperative evaluation. Add or remove rows from the systems table as needed. -->===

	=== Patient evaluation<!-- Describe the unique and important aspects of preoperative evaluation. Add or remove rows from the systems table as needed. --> ===
	{\| class="wikitable"		{\| class="wikitable"
	\|+		\|+
Line 20:		Line 18:
	\|-		\|-
	\|Pulmonary		\|Pulmonary
	\|Assess for upper respiratory infection(URI), often patients have brief intervals between URI, if febrile illness is due to otitis media, may proceed with anesthesia. However, if febrile illness with lower respiratory tract infection, patient should not proceed with anesthesia		\|Assess for upper respiratory infection(URI), often patients have brief intervals between URI, if febrile illness is due to otitis media, may proceed with anesthesia. However, if febrile illness with lower respiratory tract infection, patient should not proceed with anesthesia
	\|-		\|-
	\|Other		\|Other
	\|Assess for conductive hearing loss		\|Assess for conductive hearing loss
	\|}		\|}

	=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===		===Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. -->===

	* PO midazolam for anxiety		*Oral [[midazolam]] for anxiety
	* consider ~~IN dexetomidine~~ for anxiety and emergence delirium (alternatively, can administer intraoperatively)		*consider intranasal [[dexmedetomidine]] for anxiety and emergence delirium (alternatively, can administer intraoperatively)
	* PO acetaminophen for pain		*PO acetaminophen for pain

	== Intraoperative management ==		==Intraoperative management==

	=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===		=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. -->===

	* Standard ASA monitors		*Standard ASA monitors
	* Typically, no IV is placed. May consider placing PIV pending patient comorbidities		*Typically, no IV is placed. May consider placing PIV pending patient comorbidities

	=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===		===Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. -->===

	* Mask induction with sevoflurane +/- ~~N<sub>2</sub>O~~		*Mask induction with [[sevoflurane]] +/- [[nitrous oxide]]
	* Anesthesia mask kept on for the duration of the procedure		*Anesthesia mask kept on for the duration of the procedure
	** Rarely place LMA (severe obstruction not relieved by oral airway placement), ETT (laryngospasm)		**Rarely place LMA (severe obstruction not relieved by oral airway placement), ETT (laryngospasm)

	=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===		===Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->===

	* Supine with head turned away from surgical site		*Supine with head turned away from surgical site

	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		===Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. -->===

	* Maintained on volatile anesthetic via facemask		*Maintained on volatile anesthetic via facemask
	*Consider intramuscular fentanyl, ~~toradol~~ <ref name=":0">{{Cite journal\|last=Stricker\|first=Paul A.\|last2=Muhly\|first2=Wallis T.\|last3=Jantzen\|first3=Ellen C.\|last4=Li\|first4=Yue\|last5=Jawad\|first5=Abbas F.\|last6=Long\|first6=Alexander S.\|last7=Polansky\|first7=Marcia\|last8=Cook-Sather\|first8=Scott D.\|date=2017-01\|title=Intramuscular Fentanyl and Ketorolac Associated with Superior Pain Control After Pediatric Bilateral Myringotomy and Tube Placement Surgery: A Retrospective Cohort Study\|url=https://pubmed.ncbi.nlm.nih.gov/27861435/\|journal=Anesthesia and Analgesia\|volume=124\|issue=1\|pages=245–253\|doi=10.1213/ANE.0000000000001722\|issn=1526-7598\|pmid=27861435}}</ref>		*Consider intramuscular [[fentanyl]], [[ketorolac]]<ref name=":0">{{Cite journal\|last=Stricker\|first=Paul A.\|last2=Muhly\|first2=Wallis T.\|last3=Jantzen\|first3=Ellen C.\|last4=Li\|first4=Yue\|last5=Jawad\|first5=Abbas F.\|last6=Long\|first6=Alexander S.\|last7=Polansky\|first7=Marcia\|last8=Cook-Sather\|first8=Scott D.\|date=2017-01\|title=Intramuscular Fentanyl and Ketorolac Associated with Superior Pain Control After Pediatric Bilateral Myringotomy and Tube Placement Surgery: A Retrospective Cohort Study\|url=https://pubmed.ncbi.nlm.nih.gov/27861435/\|journal=Anesthesia and Analgesia\|volume=124\|issue=1\|pages=245–253\|doi=10.1213/ANE.0000000000001722\|issn=1526-7598\|pmid=27861435}}</ref>

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===

	* Emergence delirium common		*Emergence delirium common

	== Postoperative management ==		==Postoperative management==

	=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===		===Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. -->===

	* PACU		*PACU
	* Most cases discharged home		*Most cases discharged home

	=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===		===Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. -->===

	* Minimal post-operative pain, preferably avoiding longer acting opioids		*Minimal post-operative pain, preferably avoiding longer acting opioids

	* Multimodal analgesia		*Multimodal analgesia
	** If no PIV:		**If no PIV:
	*** PO/PR acetaminophen		***PO/PR [[acetaminophen]]
	*** IM ~~ketoralac~~<ref name=":0" />		***IM ketorolac<ref name=":0" />
	*** IM/IN fentanyl<ref name=":0" />		***IM/IN fentanyl<ref name=":0" />
	** If PIV		**If PIV
	*** PO/IV acetaminophen		***PO/IV acetaminophen
	*** IV ~~ketoralac~~		***IV ketorolac
	*** IV fentanyl		***IV fentanyl

	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		===Potential complications<!-- List and/or describe any potential postoperative complications for this case. -->===

	* Laryngospasm		*Laryngospasm

	== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==		==Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). -->==

	{\| class="wikitable wikitable-horizontal-scroll"		{\| class="wikitable wikitable-horizontal-scroll"
	\|+		\|+
	!		!
	!Myringotomy		!Myringotomy
	\|-		\|-
	\|Unique considerations		\|Unique considerations
Line 112:		Line 110:
	\|}		\|}

	== References ==		==References==

	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]

			<references />

Ebrandford: added reference for IM toreadol, fent. Edited wording to clarify that typically done with facemask only and without IV

2024-03-27T15:25:41Z

added reference for IM toreadol, fent. Edited wording to clarify that typically done with facemask only and without IV

← Older revision		Revision as of 08:25, 27 March 2024
Line 29:		Line 29:

	* PO midazolam for anxiety		* PO midazolam for anxiety
	* IN dexetomidine for anxiety and emergence delirium		* consider IN dexetomidine for anxiety and emergence delirium (alternatively, can administer intraoperatively)
	* PO acetaminophen for pain		* PO acetaminophen for pain

Line 37:		Line 37:

	* Standard ASA monitors		* Standard ASA monitors
	* ~~No access may be needed vs~~ PIV ~~x 1~~		* Typically, no IV is placed. May consider placing PIV pending patient comorbidities

	=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===		=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===
Line 43:		Line 43:
	* Mask induction with sevoflurane +/- N<sub>2</sub>O		* Mask induction with sevoflurane +/- N<sub>2</sub>O
	* Anesthesia mask kept on for the duration of the procedure		* Anesthesia mask kept on for the duration of the procedure
	* LMA		** Rarely place LMA (severe obstruction not relieved by oral airway placement), ETT (laryngospasm)
	* ETT ~~rarely indicated~~ (laryngospasm)

	=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===		=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===
Line 52:		Line 51:
	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

	* Maintained on volatile anesthetic ~~supplemented~~ with ~~analgesia~~		* Maintained on volatile anesthetic via facemask
			*Consider intramuscular fentanyl, toradol <ref name=":0">{{Cite journal\|last=Stricker\|first=Paul A.\|last2=Muhly\|first2=Wallis T.\|last3=Jantzen\|first3=Ellen C.\|last4=Li\|first4=Yue\|last5=Jawad\|first5=Abbas F.\|last6=Long\|first6=Alexander S.\|last7=Polansky\|first7=Marcia\|last8=Cook-Sather\|first8=Scott D.\|date=2017-01\|title=Intramuscular Fentanyl and Ketorolac Associated with Superior Pain Control After Pediatric Bilateral Myringotomy and Tube Placement Surgery: A Retrospective Cohort Study\|url=https://pubmed.ncbi.nlm.nih.gov/27861435/\|journal=Anesthesia and Analgesia\|volume=124\|issue=1\|pages=245–253\|doi=10.1213/ANE.0000000000001722\|issn=1526-7598\|pmid=27861435}}</ref>

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===

	* PONV prophylaxis		* Emergence delirium common
	* Emergence delirium

	== Postoperative management ==		== Postoperative management ==
Line 73:		Line 72:
	** If no PIV:		** If no PIV:
	*** PO/PR acetaminophen		*** PO/PR acetaminophen
	*** IM ketoralac		*** IM ketoralac<ref name=":0" />
	*** IM/IN fentanyl		*** IM/IN fentanyl<ref name=":0" />
	** If PIV		** If PIV
	*** PO/IV acetaminophen		*** PO/IV acetaminophen

Chris.Rishel: Text replacement - "|Respiratory" to "|Pulmonary"

2022-02-22T05:44:09Z

Text replacement - "|Respiratory" to "|Pulmonary"

← Older revision		Revision as of 22:44, 21 February 2022
Line 19:		Line 19:
	!Considerations		!Considerations
	\|-		\|-
	\|~~Respiratory~~		\|Pulmonary
	\|Assess for upper respiratory infection(URI), often patients have brief intervals between URI, if febrile illness is due to otitis media, may proceed with anesthesia. However, if febrile illness with lower respiratory tract infection, patient should not proceed with anesthesia		\|Assess for upper respiratory infection(URI), often patients have brief intervals between URI, if febrile illness is due to otitis media, may proceed with anesthesia. However, if febrile illness with lower respiratory tract infection, patient should not proceed with anesthesia
	\|-		\|-

Cornel.Chiu: Summary page

2022-01-19T16:36:58Z

Summary page

← Older revision		Revision as of 09:36, 19 January 2022
Line 5:		Line 5:
	\| monitors = Standard ASA monitors		\| monitors = Standard ASA monitors
	\| considerations_preoperative = Assessment of upper respiratory infection		\| considerations_preoperative = Assessment of upper respiratory infection
	\| considerations_intraoperative =		\| considerations_intraoperative = Laryngospasm
	\| considerations_postoperative = Laryngospasm, PONV, emergence delirium		\| considerations_postoperative = Laryngospasm, PONV, emergence delirium
	}}		}}
Line 92:		Line 92:
	\|-		\|-
	\|Unique considerations		\|Unique considerations
	\|Can be performed ~~with~~ IV access		\|Can be performed without IV access
	\|-		\|-
	\|Position		\|Position

Cornel.Chiu: Summary page

2022-01-18T17:30:07Z

Summary page

← Older revision		Revision as of 10:30, 18 January 2022
Line 6:		Line 6:
	\| considerations_preoperative = Assessment of upper respiratory infection		\| considerations_preoperative = Assessment of upper respiratory infection
	\| considerations_intraoperative =		\| considerations_intraoperative =
	\| considerations_postoperative = Laryngospasm		\| considerations_postoperative = Laryngospasm, PONV, emergence delirium
	}}		}}

	Myringotomy is a commonly performed procedure in pediatrics. The procedure involves placement of tubes within the middle ear to provide better drainage decreasing the risk of otitis media. Indication for the procedure includes recurrent otitis media episodes of six or more in one year, chronic serous otitis media, eustachian tube dysfunction and hearing loss <ref>{{Cite book\|url=https://www.worldcat.org/oclc/1117874404\|title=Anesthesiologist's manual of surgical procedures\|date=2020\|others=Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu\|isbn=978-1-4698-2916-6\|edition=Sixth edition\|location=Philadelphia\|oclc=1117874404}}</ref>. The procedure begins with an incision of the tympanic membrane. A tympanostomy tube is placed within the incision allowing for equalization of pressure and drainage of fluid in the middle ear.		Myringotomy is a commonly performed procedure in pediatrics. The procedure involves placement of tubes within the middle ear to provide better drainage decreasing the risk of otitis media. Indication for the procedure includes recurrent otitis media episodes of six or more in one year, chronic serous otitis media, eustachian tube dysfunction and hearing loss <ref>{{Cite book\|url=https://www.worldcat.org/oclc/1117874404\|title=Anesthesiologist's manual of surgical procedures\|date=2020\|others=Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu\|isbn=978-1-4698-2916-6\|edition=Sixth edition\|location=Philadelphia\|oclc=1117874404}}</ref>. The procedure begins with an incision of the tympanic membrane. A tympanostomy tube is placed within the incision allowing for equalization of pressure and drainage of fluid in the middle ear<ref>{{Cite journal\|last=Robinson\|first=Hal\|last2=Engelhardt\|first2=Thomas\|date=2017-04-19\|title=Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives\|url=https://www.dovepress.com/ambulatory-anesthetic-care-in-children-undergoing-myringotomy-and-tube-peer-reviewed-fulltext-article-LRA\|journal=Local and Regional Anesthesia\|language=English\|volume=10\|pages=41–49\|doi=10.2147/LRA.S113591\|pmc=PMC5403003\|pmid=28458577}}</ref>.

	== Preoperative management ==		== Preoperative management ==
Line 42:		Line 42:

	* Mask induction with sevoflurane +/- N<sub>2</sub>O		* Mask induction with sevoflurane +/- N<sub>2</sub>O
	* Anesthesia mask ~~may be~~ kept on for the duration of the procedure		* Anesthesia mask kept on for the duration of the procedure
	* LMA		* LMA
	* ETT rarely indicated (laryngospasm)		* ETT rarely indicated (laryngospasm)
Line 52:		Line 52:
	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

	* Maintained on volatile anesthetic		* Maintained on volatile anesthetic supplemented with analgesia

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===

	* Emergence delirium		* PONV prophylaxis
			* Emergence delirium

	== Postoperative management ==		== Postoperative management ==
Line 67:		Line 68:
	=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===		=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===

	* Minimal post-operative pain		* Minimal post-operative pain, preferably avoiding longer acting opioids

	* Multimodal analgesia		* Multimodal analgesia
Line 75:		Line 76:
	*** IM/IN fentanyl		*** IM/IN fentanyl
	** If PIV		** If PIV
	*** PO/IV acetaminophen		*** PO/IV acetaminophen
	*** IV ketoralac		*** IV ketoralac
	*** IV fentanyl		*** IV fentanyl
	*** IV hydromorphone

	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===
Line 92:		Line 92:
	\|-		\|-
	\|Unique considerations		\|Unique considerations
	\|		\|Can be performed with IV access
	\|-		\|-
	\|Position		\|Position

Cornel.Chiu: All sections

2022-01-18T16:53:37Z

All sections

New page

{{Infobox surgical procedure
| anesthesia_type = General
| airway = Anesthesia mask vs LMA vs ETT
| lines_access = No access vs PIV x 1
| monitors = Standard ASA monitors
| considerations_preoperative = Assessment of upper respiratory infection
| considerations_intraoperative =
| considerations_postoperative = Laryngospasm
}}

Myringotomy is a commonly performed procedure in pediatrics. The procedure involves placement of tubes within the middle ear to provide better drainage decreasing the risk of otitis media. Indication for the procedure includes recurrent otitis media episodes of six or more in one year, chronic serous otitis media, eustachian tube dysfunction and hearing loss <ref>{{Cite book|url=https://www.worldcat.org/oclc/1117874404|title=Anesthesiologist's manual of surgical procedures|date=2020|others=Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu|isbn=978-1-4698-2916-6|edition=Sixth edition|location=Philadelphia|oclc=1117874404}}</ref>. The procedure begins with an incision of the tympanic membrane. A tympanostomy tube is placed within the incision allowing for equalization of pressure and drainage of fluid in the middle ear.

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Respiratory
|Assess for upper respiratory infection(URI), often patients have brief intervals between URI, if febrile illness is due to otitis media, may proceed with anesthesia. However, if febrile illness with lower respiratory tract infection, patient should not proceed with anesthesia
|-
|Other
|Assess for conductive hearing loss
|}

=== Patient preparation and premedication ===

* PO midazolam for anxiety
* IN dexetomidine for anxiety and emergence delirium
* PO acetaminophen for pain

== Intraoperative management ==

=== Monitoring and access ===

* Standard ASA monitors
* No access may be needed vs PIV x 1

=== Induction and airway management ===

* Mask induction with sevoflurane +/- N<sub>2</sub>O
* Anesthesia mask may be kept on for the duration of the procedure
* LMA
* ETT rarely indicated (laryngospasm)

=== Positioning ===

* Supine with head turned away from surgical site

=== Maintenance and surgical considerations ===

* Maintained on volatile anesthetic

=== Emergence ===

* Emergence delirium

== Postoperative management ==

=== Disposition ===

* PACU
* Most cases discharged home

=== Pain management ===

* Minimal post-operative pain

* Multimodal analgesia
** If no PIV:
*** PO/PR acetaminophen
*** IM ketoralac
*** IM/IN fentanyl
** If PIV
*** PO/IV acetaminophen
*** IV ketoralac
*** IV fentanyl
*** IV hydromorphone

=== Potential complications ===

* Laryngospasm

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Myringotomy
|-
|Unique considerations
|
|-
|Position
|Supine
|-
|Surgical time
|5-10 minutes
|-
|EBL
|Minimal
|-
|Postoperative disposition
|Home
|-
|Pain management
|Mild, multimodal
|-
|Potential complications
|Laryngospasm
|}

== References ==

[[Category:Surgical procedures]]