Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work...Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work was to determine the causes of cancellation of elective surgical operations in a major pediatric surgery department in Senegal. Patients and methods: It was a prospective and descriptive study of 278 patients scheduled during a period of 13 weeks. The study took place between April 3<sup>rd</sup>, 2017, and January 31<sup>st</sup>, 2018. Mean age was 2.9 years with extremes of 3 days and 15 years. The age group of 29 days to 30 months was the most represented (62.2%). Sex ratio was 1.41. Causes of cancellation were categorized into administrative and organizational causes, patient-related causes and staff-related causes. Results: Cancellation rate was 29.4%. Patient-related causes were most common (51.2%). Upper Respiratory tract infection (URTI) was commonest reason within this category (57.5%). Organizational causes (28.1%) came second and were mainly represented by the unavailability of the operating room (60.8%) related to breakdowns of anesthesia equipment. Finally, staff-related causes (20.7%) were due for most to the unavailability of the anesthesiologist (12 cases/17). Conclusion: Majority of causes that led to cancellation of elective surgical operations in our Pediatric surgery department are related to intercurrent illnesses affecting the patient, in particular URTI.展开更多
Introduction The impact of a low-dose propofol(0.5 mg/kg)prior to extubation on perioperative respiratory adverse events(PRAEs)in children is unclear.This is particularly so in children with upper respiratory tract in...Introduction The impact of a low-dose propofol(0.5 mg/kg)prior to extubation on perioperative respiratory adverse events(PRAEs)in children is unclear.This is particularly so in children with upper respiratory tract infections(URTIs).This study aimed to determine the impact of this new approach on extubation-related adverse events in children with URTI.Methods In this randomized,double-blind prospective clinical trial(Pan African Clinical Trials Registry:PACTR 202412599188741),we recruited 144 children aged 1-6 years old with mild signs of URTI.These children were American Society of Anesthesiologists(ASA)Ⅱ-Ⅲ,undergoing abdominal surgeries with tracheal intubation using standardized anesthetic management.Patients were randomly divided into two groups:group P(propofol)received 0.5 mg propofol/kg before awake extubation and group C(control)received normal saline.Main outcomes were the incidence of PRAEs,emergence delirium,postoperative coughing and requirement for oxygen support.Statistical significance was set at p<0.05.Results Patient characteristics and intraoperative data were comparable between groups.Low-dose propofol reduced the risk of tachycardia(9.7%vs 44.4%;p=0.0001;relative risk(RR)=0.290(0.146-0.577)),respiratory adverse events(6.9%vs 25%;p=0.003;RR=0.393(0.178-0.867))and emergence delirium(1.38%vs 30.5%;p=0.0001;RR=0.074(0.011-0.507))following tracheal extubation.Low-dose propofol also reduced the need for oxygen support in the postanesthesia care unit(2.7%vs 26.3%;p=0.0001;RR=0.074(0.011-0.507))and the incidence of prolonged coughing(1.38%vs 19.4%;p=0.0001;RR=0.121(0.018-0.810)).Conclusion Use of a low dose of propofol before extubation appears to be safe and beneficial for children undergoing abdominal surgery with concurrent URTI.展开更多
文摘Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work was to determine the causes of cancellation of elective surgical operations in a major pediatric surgery department in Senegal. Patients and methods: It was a prospective and descriptive study of 278 patients scheduled during a period of 13 weeks. The study took place between April 3<sup>rd</sup>, 2017, and January 31<sup>st</sup>, 2018. Mean age was 2.9 years with extremes of 3 days and 15 years. The age group of 29 days to 30 months was the most represented (62.2%). Sex ratio was 1.41. Causes of cancellation were categorized into administrative and organizational causes, patient-related causes and staff-related causes. Results: Cancellation rate was 29.4%. Patient-related causes were most common (51.2%). Upper Respiratory tract infection (URTI) was commonest reason within this category (57.5%). Organizational causes (28.1%) came second and were mainly represented by the unavailability of the operating room (60.8%) related to breakdowns of anesthesia equipment. Finally, staff-related causes (20.7%) were due for most to the unavailability of the anesthesiologist (12 cases/17). Conclusion: Majority of causes that led to cancellation of elective surgical operations in our Pediatric surgery department are related to intercurrent illnesses affecting the patient, in particular URTI.
文摘Introduction The impact of a low-dose propofol(0.5 mg/kg)prior to extubation on perioperative respiratory adverse events(PRAEs)in children is unclear.This is particularly so in children with upper respiratory tract infections(URTIs).This study aimed to determine the impact of this new approach on extubation-related adverse events in children with URTI.Methods In this randomized,double-blind prospective clinical trial(Pan African Clinical Trials Registry:PACTR 202412599188741),we recruited 144 children aged 1-6 years old with mild signs of URTI.These children were American Society of Anesthesiologists(ASA)Ⅱ-Ⅲ,undergoing abdominal surgeries with tracheal intubation using standardized anesthetic management.Patients were randomly divided into two groups:group P(propofol)received 0.5 mg propofol/kg before awake extubation and group C(control)received normal saline.Main outcomes were the incidence of PRAEs,emergence delirium,postoperative coughing and requirement for oxygen support.Statistical significance was set at p<0.05.Results Patient characteristics and intraoperative data were comparable between groups.Low-dose propofol reduced the risk of tachycardia(9.7%vs 44.4%;p=0.0001;relative risk(RR)=0.290(0.146-0.577)),respiratory adverse events(6.9%vs 25%;p=0.003;RR=0.393(0.178-0.867))and emergence delirium(1.38%vs 30.5%;p=0.0001;RR=0.074(0.011-0.507))following tracheal extubation.Low-dose propofol also reduced the need for oxygen support in the postanesthesia care unit(2.7%vs 26.3%;p=0.0001;RR=0.074(0.011-0.507))and the incidence of prolonged coughing(1.38%vs 19.4%;p=0.0001;RR=0.121(0.018-0.810)).Conclusion Use of a low dose of propofol before extubation appears to be safe and beneficial for children undergoing abdominal surgery with concurrent URTI.
