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Minerva anestesiologica · Apr 2014
Review Practice GuidelinePreoperative evaluation in infants and children: recommendations of the italian Society of pediatric and neonatal anesthesia and intensive care (sarnepi).
- G Serafini, P M Ingelmo, M Astuto, S Baroncini, F Borrometi, L Bortone, C Ceschin, A Gentili, E Lampugnani, G Mangia, L Meneghini, C Minardi, G Montobbio, F Pinzoni, B Rosina, C Rossi, E Sahillioğlu, M Sammartino, R Sonzogni, V Sonzogni, S Tesoro, C Tognon, N Zadra, and Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI).
- Dipartimento di Anestesia e Rianimazione 1, Fondazione IRCCS Policlinico S. Matteo, Università di Pavia, Pavia, Italy - Pablo.ingelmo@muhc.mcgill.ca.
- Minerva Anestesiol. 2014 Apr 1;80(4):461-9.
BackgroundThe preoperative assessment involves the process of evaluating the patient's clinical condition, which is intended to define the physical status classification, eligibility for anesthesia and the risks associated with it, thus providing elements to select the most appropriate and individualized anesthetic plan. The aim of this recommendation was provide a framework reference for the preoperative evaluation assessment of pediatric patients undergoing elective surgery or diagnostic/therapeutic procedures.MethodsWe obtained evidence concerning pediatric preoperative evaluation from a systematic search of the electronic databases MEDLINE and Embase between January 1998 and February 2012. We used the format developed by the Italian Center for Evaluation of the Effectiveness of Health Care's scoring system for assessing the level of evidence and strength of recommendations.ResultsWe produce a set of consensus guidelines on the preoperative assessment and on the request for preoperative tests. A review of the existing literature supporting these recommendations is provided. In reaching consensus, emphasis was placed on the level of evidence, clinical relevance and the risk/benefit ratio.ConclusionPreoperative evaluation is mandatory before any diagnostic or therapeutic procedure that requires the use of anesthesia or sedation. The systematic prescription of complementary tests in children should be abandoned, and replaced by a selective and rational prescription, based on the patient history and clinical examination performed during the preoperative evaluation.
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