Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2024
Clinical Impact of Specific Extraocular Muscle Manipulation and the Oculocardiac Reflex on Postoperative Vomiting in Pediatric Strabismus Surgery: A Multicenter, Observational Study.
Strabismus surgery, which is commonly performed in children, poses a high risk of postoperative vomiting. The current anesthesia guidelines for the prevention of postoperative vomiting in children are based on heterogeneous populations involving different types of surgery, and risk factors for postoperative vomiting in, specifically, the pediatric strabismus surgery population are unclear. Moreover, the effects of manipulating the deeply attached extraocular muscles and the oculocardiac reflex on this risk remain inconclusive. ⋯ Stronger preventive measures against postoperative vomiting are recommended in healthy children undergoing strabismus surgery with inferior oblique muscle manipulation. Additionally, inferior oblique muscle manipulation should be considered a potential confounder in future related studies. However, the oculocardiac reflex was not associated with postoperative vomiting in pediatric strabismus surgery.
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Paediatric anaesthesia · Nov 2024
Measurement Properties of the Pediatric Anesthesia Emergence Delirium Scale: A Confirmatory Factor Analysis-Based Study.
Emergence delirium is a well-known and common problem in children recovering from anesthesia. The five-item Pediatric Anesthesia Emergence Delirium scale is one of the most commonly used instruments for assessing this condition, but the scale has been questioned regarding its latent structure, i.e., whether its items cover just one underlying construct. It has been suggested that the scale's first three items might identify emergence delirium better than the last two. ⋯ The Pediatric Anesthesia Emergence Delirium scale's first three items are a more valid and reliable measure of emergence delirium than its original five items.
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Paediatric anaesthesia · Nov 2024
ReviewError Traps in Developing a Pediatric Enhanced Recovery After Surgery (ERAS) Program.
Enhanced recovery after surgery (ERAS) pathways have been shown to improve patient outcomes, increase patient satisfaction, and decrease costs. First created and implemented in the adult population, these pathways are now commonplace and continue to expand in the pediatric realm. ⋯ Key themes include departmental and institutional support, stakeholder engagement, awareness of pathways, data management and dissemination, and long-term maintenance including Plan-Do-Study-Act (PDSA) cycles. Pathway development teams should be aware of these considerations and potential pitfalls, and focusing on them can promote long-term success for a well-designed pathway.