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Experience with Combining Pediatric Procedures into a Single Anesthetic
Renata M Miketic1, Joshua Uffman1, Dmitry Tumin1
1Nationwide Children's Hospital, Columbus, Ohio.
Insights
Combining multiple surgical procedures under one anesthetic is feasible for children, potentially reducing healthcare costs and parental burdens. This approach minimizes repeated anesthetic exposures for pediatric patients.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Healthcare Management
Background:
- Combining multiple surgical procedures during a single anesthetic session presents challenges for perioperative teams.
- Factors to consider include coordinating specialties, parental time and travel, and minimizing anesthetic exposures for children.
Purpose of the Study:
- To evaluate the feasibility and outcomes of combining multiple surgical procedures within a single anesthetic encounter in pediatric patients.
Main Methods:
- A retrospective review of electronic medical records at Nationwide Children's Hospital was conducted.
- Data were collected for patients undergoing two or more procedures involving two or more services during a single anesthetic encounter over one year (July 2015-June 2016).
Main Results:
- 1,120 patients underwent multiple procedures in a single anesthetic session.
- The average anesthesia time was 127 minutes, and PACU time was 64 minutes.
- The unanticipated admission rate was 7.6% (85/1,120), with a higher proportion of patients with ASA status ≥3 in this group.
Conclusions:
- Combining surgical procedures in a single anesthetic is feasible in pediatric patients.
- This approach may lead to reduced healthcare costs.
- It can also decrease parental financial and time obligations.
Abstract:
The combination of multiple procedures within a single anesthetic may provide many challenges for the perioperative team. Coordination of specialties, consideration for parental time burdens, and travel expenses as well as limiting multiple anesthetic exposures to the children are pertinent factors to consider when advocating the combination of surgical procedures.
Methods:
The electronic medical record at Nationwide Children's Hospital was retrospectively queried to obtain information on patients having a single anesthetic encounter for 2 or more procedures involving 2 or more services over 1 year (July 2015-June 2016).
Results:
One thousand one hundred twenty patients had 2 procedures during a single anesthetic encounter. The average anesthesia time was 127 ± 102 minutes, and average PACU time was 64 ± 37 minutes. The unanticipated admission rate was 85 of 1,120 cases (7.6%). Five (6%) of the unanticipated admission cases were ASA status 1, 33 (39%) were ASA status 2, and 47 (55%) were ASA status ≥3; compared with 87 (9%), 481 (50%), and 391 (41%) in the group not requiring unanticipated admission (P = 0.032) (see Fig. 1).
Conclusions:
These data demonstrate the feasibility of combining several procedures during a single anesthetic encounter and may result in decreased healthcare costs as well as limitation of parental cost and time obligations.
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