Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2025
ReviewHistorical Development and Experience of Day Surgery in China: From the Perspective of Anesthesiologists.
Day surgery has become the main mode of surgery in American and European countries, but it is still in the early stage in developing countries due to the limitation of medical technology and the backward management concept. At present, day surgery accounts for more than 60% of elective surgery in many countries in Europe and North America and more than 85% in countries such as the United Kingdom and the United States. There are 8469 ambulatory surgery centers in the United States in 2023. In China, the first ambulatory surgery center was established in 2001. In 2018, more than half of the tertiary hospitals (high-level hospitals) in China carried out day surgery, of which 639 hospitals set up ambulatory surgery centers; the proportion of day surgery in elective surgery increased to 12.8%. The annual number of day surgeries exceeded 1.25 million. In 2022, our hospital established an ambulatory surgery center managed by anesthesiologists. Day surgery requires anesthesiologists to participate in the whole process of patient management from preoperative preparation to postoperative recovery. The establishment of ambulatory surgery centers managed by anesthesiologists is of great significance to China, developing countries, and the whole world. ⋯ We call on anesthesiologists, other physicians, surgeons, nurses, and health system managers around the world to promote efficient, low-cost day surgery in developing countries and thereby increase access to surgical treatment for the world's poor.
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Paediatric anaesthesia · Feb 2025
ReviewFocused Review of Enhanced Recovery After Abdominal Trauma Surgery in the Pediatric Population and Development of a Pediatric Enhanced Recovery After Trauma Surgery Pathway.
Traumatic injuries are the leading cause of morbidity and mortality amongst pediatric patients; improving outcomes after pediatric abdominal trauma surgery could be quite impactful. Although enhanced recovery after surgery (ERAS) pathways have been successfully employed in adult trauma patients, there are few studies on pediatric enhanced recovery after abdominal trauma surgery and no consensus post trauma surgery guidelines for children. ⋯ We propose a pediatric enhanced recovery after trauma surgery pathway, which highlights several principles of ERAS pathways (multimodal analgesia, goal-directed fluid therapy, early initiation of nutrition, timely administration of antibiotics, avoidance of hypothermia, DVT prophylaxis, the early removal of drains and indwelling catheters, and patient education).
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Paediatric anaesthesia · Feb 2025
Association of Cerebral Palsy With Unanticipated Admission Following Pediatric Ambulatory Surgery.
Cerebral palsy, a neurologic disorder caused by damage to the developing brain, is a leading cause of childhood disability. Due to musculoskeletal, movement, and secondary impairments, children with cerebral palsy often require surgical care. With the growing cost of surgical care, many children with cerebral palsy are scheduled for surgery in an ambulatory setting. Whether cerebral palsy increases the risk of unanticipated admission (a critical quality indicator of care) following ambulatory surgery has not been characterized. Our objective was to determine the association of cerebral palsy with unanticipated admission following pediatric ambulatory surgery. ⋯ Level II.
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Paediatric anaesthesia · Feb 2025
Availability and Practice Patterns of Videolaryngoscopy and Adaptation of Apneic Oxygenation in Pediatric Anesthesia: A Cross-Sectional Survey of Pediatric Anesthesiologists.
Videolaryngoscopy (VL) and apneic oxygenation are highly recommended and increasingly used in pediatric anesthesia practice; yet, availability, use in recommended clinical settings (e.g., neonates, airway emergencies, and out-of-operating-room tracheal intubation), and the association of VL availability with how pediatric anesthesiologists define difficult intubation have not been explored. ⋯ VL is highly available, but the adoption of VL and apneic oxygenation for managing difficult tracheal intubation was lower than expected, given recent recommendations by pediatric anesthesia societies. There was heterogeneity in how difficult intubation was defined, resulting in a possible patient safety risk.