Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2018
Comparative Study Observational StudyCuffed endotracheal tubes in infants less than 3 kg: A retrospective cohort study.
Cuffed endotracheal tubes are being increasingly used in infants; however, current evidence in the literature mostly includes infants ≥ 3-kg weight. ⋯ This retrospective study with a small sample size found that Microcuff® cuffed endotracheal tubes may be safe in neonates < 3 kg. Well-designed randomized controlled trials are needed to address this issue definitively.
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Paediatric anaesthesia · Mar 2018
Multicenter Study Observational StudyPersistent pain following common outpatient surgeries in children: A multicenter study in Italy.
The prevalence of persistent postsurgical pain in children is over 20% after major surgeries; however, data are scarce on the prevalence, character, and risk factors among children undergoing common ambulatory surgeries. The primary aim of this study was to evaluate the prevalence of persistent pain following pediatric ambulatory surgery at 1, 3, and 6 months. Secondary aims were to identify risk factors and characterize the pain and consequences of persistent postsurgical pain. ⋯ Our data support the presence of persistent pain in pediatric patients after common surgeries. Most patients who developed persistent pain at 6 months had pain at 1 month. We recommend questioning at follow-up visit about persistent pain and functional impairment with follow-up until resolution.
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Paediatric anaesthesia · Mar 2018
Incidence and factors contributing to postdischarge nausea and vomiting in pediatric ambulatory surgical cases.
Little is known regarding the incidence and contributing factors of postdischarge nausea and vomiting in children. ⋯ We found an incidence of postdischarge nausea and vomiting of 14%. Intraoperative and postdischarge opioids increase the risk, with long-acting intraoperative opioids further accentuating the risk.
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Paediatric anaesthesia · Mar 2018
Identification of perioperative pulmonary aspiration in children using quality assurance and hospital administrative billing data.
Perioperative aspiration is a rare but potentially devastating complication, occurring in 1-10 per 10 000 anesthetics based on studies of quality assurance databases. Quality assurance reporting is known to underestimate the incidence of adverse outcomes, but few large studies use supplementary data sources. This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source. ⋯ Quality assurance data offer an efficient way to measure the incidence of rare events, but may underestimate perioperative complications. International Classification of Diseases, Ninth Revision codes for aspiration used as a secondary data source were nonspecific for perioperative aspiration, but when combined with record review yielded a 30% increase in identified cases of aspiration over quality assurance data alone. The use of administrative data therefore holds potential for supplementing quality assurance studies of rare complications.