Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2024
Reviewing "Nil Per Os" Guidance for Clear Fluids in Children Before Anesthesia: Survey of the Pediatric Anesthesia Leadership Council.
Several international pediatric anesthesia societies have endorsed a change in the traditional nil per os (NPO) cutoff of clear fluids (CF) from 2 hours to 1 hour. These recommendations were compiled from large-scale outcomes, gastric ultrasound, and quality improvement studies. The American Society of Anesthesiologists (ASA) recently published their updated guidelines. Despite the lack of prospective randomized studies with conclusive outcomes, several major children's health systems in North America have already implemented or are modifying their institutional guidelines for CF. The objectives of this survey were to evaluate the current practices, changing trends, perceived benefits, and barriers in reducing the NPO times for CF in children presenting for anesthesia. ⋯ The survey demonstrates growing trends toward implementing the reduced NPO time for CF to 1 hour nationally. Based on the current ASA guidelines, the SPA-QS committee recommends close attention to NPO times and strongly encourages CF consumption up to the recommended cutoff time. It appears reasonable to follow a 1-hour cutoff for CF as deemed appropriate by the attending anesthesiologist or the institution.
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Anesthesia and analgesia · Nov 2024
Postoperative Nausea and Vomiting in Pediatrics: Incidence and Guideline Adherence-a Retrospective Cohort Study.
Postoperative nausea and vomiting (PONV) in pediatric patients is a common and clinically significant postoperative complication. The incidence of PONV has not been extensively studied in large pediatric cohorts. Furthermore, in 2020, the Fourth Consensus Guidelines for the management of PONV were published. However, the association between perioperative factors and adherence to these guidelines remains unclear. This study aims to assess both the incidence of PONV and guideline adherence within a large and diverse pediatric population. ⋯ Our study revealed a lower-than-expected incidence of PONV in pediatric patients, highlighting the need for standardized definitions and improved reporting. Adherence to PONV guidelines was suboptimal, emphasizing the need for better implementation strategies.