Paediatric anaesthesia
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Paediatric anaesthesia · May 2021
Case ReportsAn unexpected Covid-19 diagnosis during emergency surgery in a neonate.
A 4-day-old, 3.3 kg infant presented with suspected intestinal malrotation, necessitating emergent diagnostic laparoscopy. Intra-operatively, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) came back positive. This is the first case report of emergency surgery and anesthesia in a positive SARS-CoV-2 newborn. This report highlights a neonate with an incidental positive SARS-CoV-2 test, no known exposure history, negative polymerase chain reaction maternal testing, and absence of respiratory symptoms who required modified pressure control ventilation settings to adequately ventilate with the high-efficiency particulate air filter in situ.
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Paediatric anaesthesia · May 2021
The Impact of Surgical Cancellations on Children, Families, and the Health System in an Australian Paediatric Tertiary Referral Hospital.
Reasons for elective surgery cancelations and their impact vary from one institution to another. Cancelations have emotional and financial implications for patients and their families. Our service has a particularly broad and geographically diverse patient population; hence, we sought to examine these impacts in our service. ⋯ During our study period, a total of 7870 procedures were booked. 6734 (86%) of these were completed and 1136 (14%) were canceled, with 6% canceled on the day of surgery. In 750 (66%) of these cancelations, families were successfully contacted by telephone and agreed to participate. Of these 305 (41%) cancelations were family-initiated and 444 (59%) were hospital-initiated, with these hospital-initiated cancelations occurring closer to scheduled surgery. The most common cause of cancelation was that the child could not undergo the procedure due to illness (22%) or being unable attend the hospital (14%). The greatest disruption to families and children occurred when procedures were canceled late, particularly when the cancelation occurred on the day of the planned procedure.
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Paediatric anaesthesia · May 2021
Observance of preoperative clear fluid fasting in paediatric anaesthesia: oral and written information versus text message information. A before-and-after study.
Prolonged fasting before surgery is common in pediatrics. In the literature, it is responsible for hypotension, irritability and postoperative nausea and vomiting. Despite clear instructions given during the preanesthetic consultation, fasting rules are respected in only 30%-40% of cases. We aimed to evaluate the benefit of sending a text message the day before surgery to improve the parents' observance of fasting rules. ⋯ Sending of a reminder text message to the parents the day before the surgery resulted in a significant increase in observance of fasting rules in children undergoing scheduled surgery.