Is Intravenous Access Necessary in Pediatric Patients Undergoing Ophthalmologic Examinations Under Anesthesia? A Prospective Observational Study

Ophthalmologic examinations under anesthesia (EUA) were employed in pediatric patients due to lower cooperation levels and associated discomfort during comprehensive eye examinations. There remains uncertainty regarding the necessity of intravenous (IV) placement during general anesthesia. The primary aim of the study is to investigate the impact of general anesthesia, with and without IV access, on operation time in pediatric patients undergoing EUA. Secondary objectives include assessing cardiovascular and respiratory complications and measuring parental satisfaction in both the IV and No IV groups. This prospective observational analytic study, conducted as a cross-sectional study, took place between October 2019 and October 2020, in Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Thailand. We included healthy pediatric patients aged 2 to 7 years undergoing elective ambulatory EUA. Eighty-two patients, with 41 in the IV group and 41 in the No IV group, were enrolled and included for analysis. The No IV group showed a significantly shorter median operation time (7.99 (6.63, 9.36) minutes) compared to the IV group (10.9 (9.05, 12.28) minutes), with a median difference of -2.74 minutes (95% CI -3.76, -1.69, < 0.001). In both groups, no cardiovascular or respiratory complications occurred, and there was no need for emergency IV access or drug administration. Children without IV access had higher parental satisfaction in extreme satisfaction (100% vs 48.78%; < 0.001). Providing general anesthesia for EUA without IV access in healthy pediatric patients, leading to shorter operation times and heightened parental satisfaction, can be conducted safely. The trial registration number is TCTR20191021001 from the Thai Clinical Trials Registry.