Recovery after paediatric daycase herniotomy performed under spinal anaesthesia
H Kokki1, M Heikkinen, R Ahonen
1Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland.
Insights
Spinal anesthesia is safe for pediatric herniotomy. However, most children experience pain post-surgery, requiring pain medication for several days.
Area of Science:
- Pediatric Surgery
- Anesthesiology
Background:
- Herniotomy is a common surgical procedure in children.
- Daycase procedures aim to reduce hospital stay and costs.
Purpose of the Study:
- To evaluate recovery and pain after pediatric herniotomy using spinal anesthesia.
- To assess the safety and effectiveness of spinal anesthesia in pediatric daycase herniotomy.
Main Methods:
- Prospective survey of 195 children (6 months to 10 years) undergoing herniotomy.
- Evaluation of recovery, pain, medication use, and adverse events in hospital and at home.
Main Results:
- Spinal anesthesia was successful in most cases.
- 83% of children experienced pain at home, with 19% reporting moderate to severe pain.
- Most children resumed normal activities within three days; mild headaches were reported by some.
Conclusions:
- Spinal anesthesia is a safe and effective option for pediatric herniotomy.
- Post-herniotomy pain is prevalent and requires adequate analgesia for 2-3 days.
Abstract:
In this prospective survey, recovery in hospital and at home was evaluated in 195 children aged 6 months to 10 years who had undergone herniotomy under spinal anaesthesia as a daycase procedure. Spinal anaesthesia was successful in most of the children, with only two patients being given general anaesthesia. Eighty-three percent of the children had pain at home and 19% had moderate or severe pain. Eighty-five percent of the children needed pain medication at home; the median dose of analgesics was 4 (1-9, 10th and 90th percentiles). Vomiting was noted in two of 195 children in hospital and in 10 of 192 children at home. Eleven children developed a mild position-dependent headache. Most of the children (183/191) recovered their normal daily activities during the first three postoperative days. We conclude that spinal anaesthesia is a safe and effective technique for paediatric herniotomy. Moreover, pain is common following herniotomy and children should be given analgesics for the first two or three postoperative days.
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