Anesthetic considerations for pediatric outpatient surgery

Emhardt, John D.; Saysana, Chansamone; Sirichotvithyakorn, Pornarun

doi:10.1053/j.sempedsurg.2004.04.003

Cited by 12 publications

(4 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At Riley Hospital in Indianapolis for children, Emhart et al [1] divided the duration of preoperative fasting according to the nature of the food: clear liquids 2 hours, solids up to 8 hours.…”

Section: Long Duration Of Pre-operative Fastingmentioning

confidence: 99%

“…The purpose of pre-operative fasting is to overcome the risk of pulmonary inhalation leading to a chemical pneumopathy according to Cote et al [1], while avoiding a too prolonged period of fasting exposing to the risk of hypoglycemia and/ or dehydration mainly in the small infant. As a source of discomfort and dissatisfaction, the rules of preoperative fasting have evolved considerably in recent years since the recommendations of the American Society of Anesthesiologists (ASA) of 1999, calling into question the dogma of strict fasting since midnight established arbitrary way dating from the end of the Second World War [2].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Improvement in the duration of pre-operative fasting in children

Benouaz¹,

Batouche²,

Benatta³

et al. 2018

anesthesiology

View full text Add to dashboard Cite

Source of discomfort and dissatisfaction, the rules of pre-operative fasting have evolved a lot in recent years.Objective: To evaluate the duration of preoperative fasting in children and the degree of parental support for this strategy. Materials and Methods:Prospective mono-centric study on the implementation of a preoperative fasting strategy in children. Pediatric surgery department of the Teaching University Hospital (TUH) of Sidi-Bel-Abbès over a period of three years from July 2015 to June 2018. Included were all children from 6 months-15 years, who are asked the indication of anesthesia for minor surgery. We gathered the respect and understanding of the parents of preoperative fasting.Results: One thousand three children were included in the study, the mean age was: 62.01 ± 44.14 months, the sex ratio was 3.6/1 with male predominance. The majority of children were under six years old. The socio-cultural level of parents was medium to high in 88.4% of cases. The mean duration of preoperative fasting was 6.9 ± 4.16 hours and ranged from 2 hours to more than 11 hours. Almost 70% of children had a six-hour fast during the second year.Discussion: In our work, the vast majority of parents respected the pre-op fasting of their children. The improvement in the duration of preoperative fasting was done through a follow-up protocol by the entire pediatric surgery team. The application of the rules of fasting by parents must be strict and simple.

show abstract

Section: Long Duration Of Pre-operative Fastingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improvement in the duration of pre-operative fasting in children

Benouaz¹,

Batouche²,

Benatta³

et al. 2018

anesthesiology

View full text Add to dashboard Cite

show abstract

“…On average, 3.9 million surgeries and procedures are performed on children annually in the United States (Rabbitts & Groenewald, 2020), and at least 60% of these are outpatient procedures (Emhardt et al, 2004; Rabbitts et al, 2010). Pediatric outpatient procedures, also called ambulatory or same-day procedures, are becoming prevalent for elective procedures such as endoscopy and colonoscopy (Friedt & Welsch, 2013).…”

Section: Introductionmentioning

confidence: 99%

Design of Pediatric Outpatient Procedure Environments: A Pilot Study to Understand the Perceptions of Patients and Their Parents

Goel,

Mihandoust,

Joseph

et al. 2024

HERD

View full text Add to dashboard Cite

Objective: To understand parent and child perception of spaces experienced during outpatient procedures and to measure their anxiety in these spaces. Background: Same-day procedures are becoming prevalent among children in the United States. While studies conducted in different types of healthcare settings show that the physical environment influences healthcare experiences of patients, there is a lack of research on patient and family perceptions of the physical environment of the outpatient centers where such procedures are conducted. Methods: This study used ecological momentary assessment to collect patient experience and anxiety data at different points during the patient’s journey through an ambulatory surgical center where pediatric gastrointestinal (GI) procedures were performed. Objective and subjective measures of anxiety were collected. A Qualtrics survey asked participants’ perceptions about four spaces—waiting, preprocedure, procedure, and recovery. Results: Child participants reported liking murals, double chairs, patient beds, wall color, and access to a television. They disliked medical equipment and lack of child-friendly furniture. Most parents liked the murals, access to a television, and nature photos, while disliking the lack of privacy, lack of toys in waiting areas, and lack of child-friendly furniture. On average, both children and parents experienced the highest anxiety levels before and during the procedure and the lowest during recovery. Between the four spaces, no significant differences were observed in the heart rate variability and skin conductance responses for both groups. Conclusions: Despite the outpatient nature of the procedures, participants experienced anxiety before the GI procedure. Comfortable design features that provide distractions are preferred by children and their parents.

show abstract

“…Optimal postop-erative analgesia is necessary to assure a pain-free patient which is a prerequisite for parent satisfaction and unnecessary readmissions. 1 Preincision caudal anesthesia is a wellestablished technique for peri-and postoperative pain reduction which is well applicable for outpatients. Today, ultrasound-assisted techniques have improved the success rate, especially in small children.…”

Section: Introductionmentioning

confidence: 99%

Caudal Block versus Wound Infiltration for Inguinal Procedures in Young Children: A Randomized Clinical Study

et al. 2023

View full text Add to dashboard Cite

Introduction Inguinal procedures in children are frequent and typically performed in an outpatient setting. We aimed to analyze whether there is a difference in postoperative pain scores and setup time (start of anesthesia management to incision time) when comparing caudal block (CB) with local wound infiltration. Materials and Methods We enrolled pediatric outpatients scheduled for inguinal procedures. Patients were randomized to receive either preincision CBs or end-of-procedure local wound infiltration. Postoperative pain scores until 24 hours postoperatively and setup time were analyzed. Results Fifty-two patients were included in the study. Thirty patients received a CB, and 22 patients received local infiltration (LI). There was no significant difference in postoperative pain scores. Setup time was significantly higher in the CB group: median 22.5 minutes IQR (16–46 minutes) compared with 17 minutes in the LI group IQR (10–35 minutes), p-value of 0.0026. Conclusion Both CB and LI result in good postoperative pain control after inguinal procedures in pediatric outpatients. Since LI is less time consuming and has lower risks for complications, we recommend this technique for inguinal procedures in pediatric outpatients. Our findings will need to be confirmed in larger cohorts, but we believe the evidence generated with this study has the potential to positively influence patient care, operating room efficiency, and costs.

show abstract

Anesthetic considerations for pediatric outpatient surgery

Cited by 12 publications

References 63 publications

Improvement in the duration of pre-operative fasting in children

Improvement in the duration of pre-operative fasting in children

Design of Pediatric Outpatient Procedure Environments: A Pilot Study to Understand the Perceptions of Patients and Their Parents

Caudal Block versus Wound Infiltration for Inguinal Procedures in Young Children: A Randomized Clinical Study

Contact Info

Product

Resources

About