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[Ambulatory pediatric anesthesia. Personal experience]
G Barbone1, L Montinaro, T Fiore
1Istituto di Anestesiologia e Rianimazione, Università degli Studi di Bari.
Insights
Outpatient pediatric anesthesia for healthy children (ASA I-II) undergoing minor procedures is safe and effective. Rapid recovery and good pain control were observed, with minimal complications.
Area of Science:
- Pediatric Anesthesiology
- Ambulatory Surgery
Context:
- Critically examines preoperative management and anesthetic techniques for pediatric patients undergoing ambulatory procedures.
- Focuses on 86 ASA I-II pediatric patients aged 6 months to 11 years.
Purpose:
- To evaluate the safety and efficacy of outpatient pediatric anesthesia for minor surgeries and endoscopy.
- To assess perioperative effects and patient/parent acceptance.
Summary:
- Various anesthetic techniques and drugs were employed, tailored to patient age and procedure type.
- Rapid and smooth patient arousal was consistently observed.
- Adequate residual analgesia was achieved in most cases, with minimal complications and few delayed discharges.
Impact:
- Demonstrates that outpatient pediatric anesthesia is a viable option for ASA I-II patients.
- Highlights the importance of psychological preparation for patients and parents.
- Supports the safety and acceptance of ambulatory anesthesia in pediatric settings.
Abstract:
The authors critically examine the preoperative management, the various anaesthetic techniques, the perioperative undesired effects in eighty six ASA I-II paediatric patients (age 6 months-11 years) submitted to ambulatorial anaesthesia for minor surgery or endoscopy. The importance of the psychological approach to patients and parents is enhanced. The preoperative screening included physical examination, ECG and simple laboratory tests. Various anaesthetic techniques (tracheal intubation and muscle relaxation with mechanical ventilation or spontaneous breathing) and many variously combined anaesthetic drugs (propofol 2 mg/kg, ketamine 1.5 mg/kg, diazepam 0.15 mg/kg, thiopental 3-4 mg/kg, halothane 1-2 MAC, fentanyl 1 microgram/kg) were employed depending on the quality of the surgical procedure and the conditions and the age of the patient. The results show that arousal was always rapid and smooth. The residual analgesia was sufficient in 74 cases; the other patients received rectal paracetamol 250 mg. No major complication was observed and only 6 patients were discharged 1 day later on account of vomiting or low Steward score. In conclusion outpatient paediatric anaesthesia has no contraindication for ASA I-II patients, shows no major complication and is well accepted by the patients and their patients.