Incidence of postoperative nausea and vomitingin paediatric ambulatory surgery (original) (raw)
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Audit of postoperative nausea and vomiting in paediatric day case surgery
JPMA. The Journal of the Pakistan …, 2011
Objective: To assess the incidence of PONV, delay in discharge or unplanned admissions in paediatric surgical cases done at the Surgical Day Care Unit at Aga Khan University between January and July 2009. Methods: All paediatric ASA 1-2 cases, from 6 months to 18 years of age undergoing day case surgeries at the Surgical day care unit were included in this retrospective audit. Data was collected on a designed form filled with information from preoperative, intraoperative and postoperative recovery forms. Any relevant data was also noted from nurses notes in recovery room and step down unit. Episodes of vomiting, delay in discharge, or unplanned admission due to PONV were documented. Data was analyzed on SPSS 14. Results: Out of 163 patients only one patient (0.6%) had an episode of vomiting in the recovery room and two patients (1.2 %) had vomiting in the step down unit. There was no delay in discharge or unplanned admission due to PONV in paediatric day cases during the period of our audit. Conclusion: The incidence of postoperative vomiting in paediatric day cases at our day care unit does not justify polymodal prophylaxis as a protocol for PONV.
Colombian journal of anesthesiology
Introduction: Postoperative nausea and vomiting are frequent adverse effects of anesthesia and surgery. Impact is greater in pediatric populations compared to adults and the reported incidences are heterogeneous. Objective: To describe the incidence of postoperative vomiting in a pediatric population and to identify associated risk factors. Materials and methods: This prospective cohort study included 190 children aged 3 to 12 years undergoing surgery and anesthesia in a maternal and child health clinic in Bucaramanga (Colombia). The main outcome variable was postoperative vomiting. Data were analyzed using bivariate, multivariate analysis and logistic regression to assess the associated risk factors. Results: The overall incidence of postoperative vomiting was 18.95% (95% CI: 13.32 - 24.57), with a higher incidence at home vs. hospital (12.63% vs. 9.47%). After adjustment, associated risk factors were anesthesia time longer than 45 minutes (OR: 2.33; 95% CI: 1.10-4.90) and postoper...
Introduction Anaesthesia is a field procedure. Paediatric anaesthesia requires vigilance and rigour at all stages. It must be carried out in an adapted structure by a team accustomed and updating its knowledge. What complications of paediatric anaesthesia in outpatient surgery? Objective Evaluation of immediate postoperative complications of paediatric anaesthesia in outpatient surgery. Patients and method Prospective, descriptive and analytical study of 160 cases of outpatient surgery performed at the national hospital of Zinder over six months from 1 January to 30 June 2018. Included were children aged 01 month to 05 years operated during outpatient surgery. The variables were epidemiological data, ASA class, type of anaesthesia, operative indications and patient outcome. Results During the study period 160 anaesthesias were performed. The mean age of the patients was 27.44 months with extremes from 01 month to 60 months. The sex ratio was 3.8 in favour of boys. ASA I class represented 80% of the patients. General anaesthesia with intubation was the technique of choice in 82.50%. The drugs frequently used were ketamine, propofol, halothane and fentanyl. The main operative indication was hernia in 63.12% of cases. The complications observed were bursal haematoma (06.87%), respiratory complications (03.12%) and hyperthermia (01.25%) of cases. The evolution was favourable for all patients and no deaths were recorded. Conclusion Paediatric anaesthesia for outpatient surgery generates fewer complications if it is carried out in a suitable structure and by staff who are used to it and have updated their knowledge. This practice should be popularised as it allows us to relieve congestion in our departments with limited beds.
Society for Ambulatory Anesthesia Guidelines for the Management of Postoperative Nausea and Vomiting
Anesthesia & Analgesia, 2007
The present guidelines were compiled by a multidisciplinary international panel of individuals with interest and expertise in postoperative nausea and vomiting (PONV) under the auspices of The Society of Ambulatory Anesthesia. The panel critically evaluated the current medical literature on PONV to provide an evidencebased reference tool for the management of adults and children who are undergoing surgery and are at increased risk for PONV. In brief, these guidelines identify risk factors for PONV in adults and children; recommend approaches for reducing baseline risks for PONV; identify the most effective antiemetic monotherapy and combination therapy regimens for PONV prophylaxis; recommend approaches for treatment of PONV when it occurs; and provide an algorithm for the management of individuals at increased risk for PONV. (Anesth Analg 2007;105:1615-28) Post operative nausea and vomiting (PONV) is a continuing concern in surgical patients and the management of this problem is still confusing. In the United States, more than 71 million inpatient and outpatient operative procedures are performed each year (1). Untreated, PONV occurs in 20%-30% of the
Applicability of risk scores for postoperative nausea and vomiting in adults to paediatric patients
British Journal of Anaesthesia, 2004
Background. Scores to predict the occurrence of postoperative vomiting (PV) or nausea and vomiting (PONV) are well established in adult patients. The aim of this survey was to evaluate the applicability of risk scores developed and tested in adult patients in 983 paediatric patients (0-12 yr) undergoing various surgical procedures. Method. The predictive properties of five models were compared with respect to discriminating power (measured by the area under a receiver operating characteristic curve) and calibration (comparison of the predicted and the actual incidences of the disease by weighed linear regression analysis). Results. The cumulative incidence of PV was 33.2% within 24 h. The discriminating power was low and insufficient in all models tested (0.56-0.65). Furthermore, the predicted incidences of the scores correlated only vaguely with the actual incidences observed. Conclusion. Specialized scores for children are required. These might use the history of PV, strabismus surgery, duration of anaesthesia >45 min, age >5 yr and administration of postoperative opioids as independent risk factors.
Postoperative morbidity in pediatric patients following dental treatment under general anesthesia
European Oral Research
Purpose The aims of this study were to investigate post-operative complications in pediatric patients 24 and 72 hours after general anesthesia (GA) and to identify any associations between dental procedures and complications. Materials and Methods One hundred and thirty three healthy pediatric patients who had undergone dental treatment under GA (age range: two to nine years) were included in this study. The project was designed as a prospective, observational study supported by a questionnaire that collected data on children's post-operative complaints. Preoperative data were obtained from patients' files and included age, gender, medical condition and admission type (inpatient or outpatient) variables. The postoperative complaints were assessed either by phone contact or by face-to-face interviews using a questionnaire 24 and 72 hours after treatment. Results 69.9% of children reported one or more complaints after 24 hours and 35.3% after 72 hours. Coughing and pain (27.1%), inability to eat (24.8%), psychological changes (24.1%) and a sore throat (21.1%) were the most common complaints during the first day. After 72 hours, the severity and rate of the complications decreased significantly (p < 0.05). Conclusion Post-operative complaints following dental treatment under GA tended to be of mild severity and were mainly limited to the first day after the procedure.
Prevention and Management of Postoperative Nausea and Vomiting in Adults
AORN Journal, 2009
In early 2007, patients at our small community hospital's outpatient surgery center experienced postoperative nausea and postoperative nausea and vomiting (PONV) at a rate of 27% to 35%. Many record reviews and a written survey of nurses in the postanesthesia care unit and same day surgery center revealed that little or no risk assessment and no consistent prophylaxis or treatment were in use by nurses, physicians, or anesthesia care providers.
Acta Anaesthesiologica Scandinavica, 1999
Our study confirms a relatively high incidence of PONV in children who undergo general anaesthesia for RFCA, and we have identified factors which significantly increase the risk of developing this significant complication. oxide and prophylactic ondansetron compared to an incidence of PONV of 63% in patients who received volatile-based anesthesia, nitrous oxide and prophylactic ondansetron . These numbers suggest that RFCA may represent an increased risk for PONV in the pediatric population.