A Conscious Sedation Protocol for Videolaryngostroboscopy in Pediatric Patients

Abstract

Objective. To determine best sedation protocol for videolaryngostroboscopy in children unable to tolerate non-sedated evaluation.Materials and Methods.Consecutive case series of 10 children with voice disturbances, unable to tolerate nonsedated videolaryngostroboscopy at an academic tertiary care children’s hospital. Flexible fiberoptic videolaryngostroboscopy was performed and interpreted by pediatric otolaryngologist and speech and language pathologist. Sedation was administered with newly described protocol that allowed functional portion of evaluation.Main Outcome Measures: ability to follow commands and tolerate flexible fiberoptic videolaryngostroboscopy.Secondary Outcome Measures: total phonation time, complications, need for subsequent videolaryngostroboscopic attempts, clinical outcomes, and follow-up.Results. 10 children underwent procedure under conscious sedation. 9/10 children were able to perform simple tasks and maintain adequate phonation time to complete stroboscopic exam. 1/10 patients failed to complete exam because of crying during entire exam. Mean exam time was 2 minutes 52 seconds (SD 86 seconds), phonation time is 1 minute 44 seconds (SD 60 seconds), and number of tasks completed was 10.5 (SD 8.6).Conclusions. Conscious sedation for videolaryngostroboscopy can be safely and effectively performed in children unable to comply with nonsedated examination. Such studies provide valuable diagnostic information to make a diagnosis and to devise a treatment plan.