A Peri-Operative Audit of the Paediatric Cochlear Implantation Programme at the Singapore General Hospital

Paediatric cochlear implantation has become an established procedure for treating irreversible hearing loss. The aim of this survey was to review the peri-operative anaesthetic management of this programme since its inception.Methods: We conducted a retrospective clinical audit of 184 paediatric (age <12) cochlear implantation cases by reviewing clinical records. The surgery was performed by the same surgeon at the Singapore General Hospital (SGH) from 1997 to 2010.Results: A total of 184 procedures (including five bilateral cases) were performed on 173 patients. The average age (mean [standard deviation, range]) at the time of surgery was 3.7 (±2.6, 0.7–11) years. The mean duration of the unilateral and bilateral implantation procedures were 3.2 (±1.0, 1.2–6.5) hours and 4.7 (±0.8, 4–6) hours respectively. Inhalational anaesthesia (66.3%) was the most popular choice for induction. 15 (8.1%) patients required additional analgesia in the post-anaesthetic care unit. In the ward, 14 patients (7.6%) required stronger analgesia in addition to paracetamol. Peak paracetamol requirement (22.9 [±16.6] mg/kg) was on the first postoperative day. Nausea and vomiting was reported in 19 (10.3%) procedures. The correlation between increasing age and post-operative nausea and vomiting was statistically significant (p<0.05) as was the association between age and analgesic requirements. The average duration of hospital stay was 3.2 (±1.0, 1–6) days. Mean age at time of surgery as well as duration of unilateral implantation procedures decreased over time. A trend towards same day admission (SDA) was also noted.Conclusion: Cochlear implantation in paediatric patients is a relatively safe procedure involving few complications.