Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2023
Multicenter StudyIntraoperative fluid administration volumes during pediatric liver transplantation and postoperative outcomes: A multicenter analysis.
Fluid administration is an important aspect of the management of children undergoing liver transplantation and may impact postoperative outcomes. Our aim was to evaluate the association between volume of intraoperative fluid administration and our primary outcome, the duration of postoperative mechanical ventilation following pediatric liver transplantation. Secondary outcomes included intensive care unit length of stay and hospital length of stay. ⋯ Other modifiable factors should be sought which may lead to improved postoperative outcomes in this highly vulnerable patient population.
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Paediatric anaesthesia · Sep 2023
Outcomes for 41 260 pediatric surgical patients with opioid-free anesthesia: One center's experience.
Opioid use is common and associated with side effects and risks. Consequently, analgesic strategies to reduce opioid utilization have been developed. Regional anesthesia and multimodal strategies are central tenets of enhanced recovery pathways and facilitate reduced perioperative opioid use. Opioid-free anesthesia (OFA) protocols eliminate all intraoperative opioids, reserving opioids for postoperative rescue treatment. Systematic reviews show variable results for OFA. ⋯ These QI projects demonstrated that most pediatric ambulatory and select inpatient surgeries are amenable to OFA techniques which may reduce PONV without worsening pain.
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Paediatric anaesthesia · Sep 2023
Intraoperative transfusion practice and associated outcomes following neonatal surgery in a middle-income country: A 5-year single center retrospective review.
Neonates undergoing surgery are at greater risk of requiring packed red blood cell transfusion. Pediatric transfusion practices vary widely between countries and institutions, especially in the management of neonates. ⋯ Intraoperative blood product transfusion occurred at a much higher rate with a high median pre-transfusion hemoglobin compared to other studies.
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Paediatric anaesthesia · Sep 2023
A service evaluation of the impact of parental information provision on analgesia administration at home posttonsillectomy.
Tonsillectomy and adenotonsillectomy are together the most common pediatric surgical procedure and are increasingly performed as day cases. Postoperative pain is commonly severe for 1-2 weeks, but parental analgesia concerns lead to poor analgesia prescription compliance and under administration. This service evaluation assessed parental compliance with analgesia, elicited parental concerns, and obtained parental suggestions for improving the current written advice. ⋯ The breadth of unmet information needs identified in this service evaluation, alongside parental suggestions, will be used to improve the current written advice with the aim to improve the postoperative pain experience at home. These include information on length of analgesic course, safety of ibuprofen and paracetamol coadministration for analgesia, and details about morphine administration, including safety, side effects, and indication.