Perioperative medicine in paediatric anaesthesia

An understanding of the maintenance of normal body temperature, and the manner in which surgery, anaesthesia, and related procedures may disturb thermoregulation, is of considerable importance in paediatric anaesthesia. The subject of accidental hypothermia, with particular reference to the newborn infant, is reviewed; and hyperpyrexia is briefly discussed.

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The Impact of Paediatric Anaesthesia Information Leaflet in Reducing Parental and Child Anxiety in Paediatric Surgery

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v18i2.617 ◽

2020 ◽

Vol 18 (2) ◽

Author(s):

Marni Mahfuzah Abdul Wahid

Keyword(s):

Elective Surgery ◽

Controlled Trial ◽

Anxiety Level ◽

Paediatric Anaesthesia ◽

Anxiety State ◽

Paediatric Surgery ◽

Information Leaflet ◽

Control Groups ◽

And Control ◽

The Impact

Introduction: The process of anaesthesia is one of the most important anxiety precipitating factors for both parent and child who is going for operation. Parental anxiety may adversely affect the children during perioperative period. Studies have shown that anxious parents would want to be provided with more information prior to their child’s surgery. We examined the effects of additional paediatric information leaflet on parents and children in reducing pre-operation anxiety. Materials and methods: This was a randomized controlled trial involving 70 parentchild dyads in Hospital Raja Perempuan Zainab II (HRPZ II), Kelantan. Inclusion criteria were child aged 3 to 12 years old who underwent elective surgery. Parents were assigned to intervention and control groups. The former received the information leaflet and the later received standard preparation.. Parents were compared on their anxiety level using Depression Anxiety Stress Scales 21 (DASS-21) (anxiety domain) in the holding area. Children were compared on their emotional state level before induction of anaesthesia using Children’s Emotional Manifestation Scale (CEMS). Results: The number of parents who were anxious was similar in both groups (11 (31%) vs. 7 (21%), p =.34). There were no differences in the children’s anxiety state between interventional and control groups as depicted by the CEMS score (7.5 (6.0-9.75) vs. 8.0 (7.0-15.0), p= .12). Conclusion: Parent-child dyads in HRPZ II did not show improvement in the anxiety level with the inclusion of paediatric anaesthesia information leaflet. Further study is needed with larger number of participants involving other selected tertiary hospitals in Malaysia.

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Effects of dexmedetomidine versus midazolam for premedication in paediatric anaesthesia with sevoflurane: A meta-analysis

Journal of International Medical Research ◽

10.1177/0300060517704595 ◽

2017 ◽

Vol 45 (3) ◽

pp. 912-923 ◽

Cited By ~ 6

Author(s):

Ji-Feng Feng ◽

Xiao-Xia Wang ◽

Yan-Yan Lu ◽

Deng-ge Pang ◽

Wei Peng ◽

...

Keyword(s):

Lower Incidence ◽

Health Management ◽

Meta Analysis ◽

Postoperative Nausea And Vomiting ◽

Postoperative Recovery ◽

Paediatric Anaesthesia ◽

Parental Separation ◽

Paediatric Surgery ◽

Rescue Analgesia ◽

Dichotomous Variables

Background Dexmedetomidine (DEX), an α2-adrenergic receptor agonist, produces ideal sedation and early postoperative recovery for premedication in paediatric surgery, reducing preoperative anxiety and facilitating smooth induction of anaesthesia. We performed a meta-analysis to compare the effects of DEX and midazolam (MDZ) in paediatric anaesthesia with sevoflurane. Methods PubMed, Ovid, Web of Science, and Public Health Management Corporation were searched through December 2016 for randomized controlled trials (RCTs) that compared DEX and MDZ in children undergoing sevoflurane anaesthesia. The risk ratio (RR) with 95% incidence interval (95%CI) was used for dichotomous variables. Results Twelve RCTs involving 422 patients in the DEX group and 448 patients in the MDZ group were included. Patients in the DEX group had a significantly lower incidence of unsatisfactory sedation (RR [95%CI] = 0.71 [0.57–0.89]), unsatisfactory parental separation (RR [95%CI] = 0.56 [0.35–0.87]), and rescue analgesia (RR [95%CI] = 0.52 [0.35–0.77]) than patients in the MDZ group. However, both groups had a similar incidence of unsatisfactory mask acceptance, emergence agitation, and postoperative nausea and vomiting. Conclusion Compared with MDZ, DEX is beneficial in paediatric anaesthesia with sevoflurane because of its lower incidence of unsatisfactory sedation, parental separation, and rescue analgesia.

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Jones' Clinical Paediatric Surgery: Diagnosis and Management, 5th edn.

Child Care Health and Development ◽

10.1046/j.1365-2214.2001.0190b.x ◽

2001 ◽

Vol 27 (4) ◽

pp. 378-379

Author(s):

D Scarr

Keyword(s):

Paediatric Surgery ◽

Diagnosis And Management

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Pulmonary atelectasis during paediatric anaesthesia: CT scan evaluation and effect of positive endexpiratory pressure (PEEP)

Pediatric Anesthesia ◽

10.1046/j.1460-9584.1999.00340.x ◽

1999 ◽

Vol 9 (3) ◽

pp. 225-228 ◽

Cited By ~ 6

Author(s):

G Serafini ◽

G Cornara ◽

F Cavalloro ◽

A Mori ◽

R Dore ◽

...

Keyword(s):

Ct Scan ◽

Paediatric Anaesthesia ◽

Pulmonary Atelectasis ◽

Positive Endexpiratory Pressure

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Absorbable suture material in carotid surgery

VASA ◽

10.1024/0301-1526/a000468 ◽

2015 ◽

Vol 44 (6) ◽

pp. 451-457 ◽

Cited By ~ 4

Author(s):

Vincenzo Gasbarro ◽

Luca Traina ◽

Francesco Mascoli ◽

Vincenzo Coscia ◽

Gianluca Buffone ◽

...

Keyword(s):

Suture Material ◽

Absorbable Suture ◽

Paediatric Surgery ◽

Carotid Surgery ◽

Suture Materials ◽

Absorbable Suture Material ◽

Absorbable Sutures ◽

Group A ◽

Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

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