Pediatric Anesthesiologists Increase Operating Room Efficiency for Pediatric Adenotonsillectomies

Abstract

Objectives: (1) Determine whether Accreditation Council for Graduate Medical Education fellowship-trained pediatric anesthesiologists improve the efficiency of pediatric operations at hospitals that do not have dedicated pediatric operating rooms (ORs). (2) Determine what anesthesia practices may account for a difference in efficiency between general and pediatric anesthesiologists. Methods: This retrospective chart review study compared the anesthesia-controlled time (ACT) between pediatric and general anesthesiologists for pediatric adenotonsillectomies performed at an academic county hospital without dedicated pediatric operating rooms (ORs). All patients age 12 years and under who underwent tonsillectomy or adenotonsillectomy from January 2008 to July 2013 at San Francisco General Hospital were included. Patient demographics, surgical time, ACT, and anesthesia techniques were compared between pediatric and general anesthesiologists. Results: Pediatric anesthesiologists had significantly shorter ACT than general anesthesiologists (33 ± 12 vs 47 ± 15 minutes; P < .0001). Surgical time was also shorter for cases staffed by pediatric anesthesiologists (44 ± 14 vs 54 ± 23 minutes; P < .05). Conclusions: These findings suggest that, at hospitals without dedicated pediatric ORs, staffing pediatric operations with fellowship-trained pediatric anesthesiologists may be an effective strategy for increasing OR efficiency and reducing costs without compromising patient care.