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Preoperative Evaluation in Pediatric Anesthesia

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Book cover Perioperative Medicine in Pediatric Anesthesia

Abstract

The preoperative assessment is the process of evaluating the patient’s clinical condition, aimed to define the risks and eligibility for anesthesia and surgery. The preoperative evaluation is mandatory before any diagnostic or therapeutic procedure requiring anesthesia or sedation. The preoperative evaluation should provide the elements to select a shared and individualized perioperative plan. The prescription of complementary tests in children should be selective and based on the patient history and clinical examination. The preoperative evaluation is an anesthesiologist’s responsibility, and only an anesthesiologist can define the eligibility for anesthesia.

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References

  1. Kohn LT, Corrigan JM, Donaldson MS (2000) To err is human: building a safer health system. National Academy Press, Washington

    Google Scholar 

  2. Aplin S, Baines D, DE Lima J (2007) Use of the ASA Physical Status Grading System in pediatric practice. Paediatr Anaesth 17(3):216–222

    Article  PubMed  Google Scholar 

  3. Jacqueline R, Malviya S, Burke C, Reynolds P (2006) An assessment of interrater reliability of the ASA physical status classification in pediatric surgical patients. Paediatr Anaesth 16(9):928–931

    Article  PubMed  Google Scholar 

  4. Burgoyne LL, Smeltzer MP, Pereiras LA, Norris AL, De Armendi AJ (2007) How well do pediatric anesthesiologists agree when assigning ASA physical status classifications to their patients? Paediatr Anaesth: Upper Saddle River, New Jersey 17(10):956–962

    Google Scholar 

  5. Udupa AN, Ravindra MN, Chandrika YR, Chandrakala KR, Bindu N, Watcha MF (2015) Comparison of pediatric perioperative risk assessment by ASA physical status and by NARCO-SS (neurological, airway, respiratory, cardiovascular, other-surgical severity) scores. Paediatr Anaesth 25(3):309–316

    Article  PubMed  Google Scholar 

  6. Weinberg AC, Huang L, Jiang H, Tinloy B, Raskas MD, Penna FJ, Freilich DA, Buonfiglio HB, Retik AB, Nguyen HT (2011) Perioperative risk factors for major complications in pediatric surgery: a study in surgical risk assessment for children. J Am Coll Surg 212(5):768–778

    Article  PubMed  Google Scholar 

  7. Wood G, Barayan G, Sanchez DC, Inoue GN, Buchalla CA, Rossini GA, Trevisani LF, Prado RR, Passerotti CC, Nguyen HT (2013) Validation of the pediatric surgical risk assessment scoring system. J Pediatr Surg 48(10):2017–2021

    Article  PubMed  Google Scholar 

  8. Paterson N, Waterhouse P (2011) Risk in pediatric anesthesia. Paediatr Anaesth 21(8):848–857

    Article  PubMed  Google Scholar 

  9. Murat I, Constant I, Maud’huy H (2004) Perioperative anaesthetic morbidity in children: a database of 24,165 anaesthetics over a 30-month period. Paediatr Anaesth 14(2):158–166

    Article  PubMed  Google Scholar 

  10. Jimenez N, Posner KL, Cheney FW, Caplan RA, Lee LA, Domino KB (2007) An update on pediatric anesthesia liability: a closed claims analysis. Anesth Analg 104(1):147–153

    Article  PubMed  Google Scholar 

  11. Morray JP, Geiduschek JM, Ramamoorthy C, Haberkern CM, Hackel A, Caplan RA, Domino KB, Posner K, Cheney FW (2000) Anesthesia-related cardiac arrest in children: initial findings of the Pediatric Perioperative Cardiac Arrest (POCA) Registry. Anesthesiology 93(1):6–14

    Article  CAS  PubMed  Google Scholar 

  12. Ramamoorthy C, Haberkern CM, Bhananker SM, Domino KB, Posner KL, Campos JS, Morray JP (2010) Anesthesia-related cardiac arrest in children with heart disease: data from the Pediatric Perioperative Cardiac Arrest (POCA) registry. Anesth Analg 110(5):1376–1382

    Article  CAS  PubMed  Google Scholar 

  13. Bhananker SM, Ramamoorthy C, Geiduschek JM, Posner KL, Domino KB, Haberkern CM, Campos JS, Morray JP (2007) Anesthesia-related cardiac arrest in children: update from the Pediatric Perioperative Cardiac Arrest Registry. Anesth Analg 105(2):344–350

    Article  PubMed  Google Scholar 

  14. Flick RP, Sprung J, Harrison TE, Gleich SJ, Schroeder DR, Hanson AC, Buenvenida SL, Warner DO (2007) Perioperative cardiac arrests in children between 1988 and 2005 at a tertiary referral center: a study of 92,881 patients. Anesthesiology 106(2):226–237

    Article  PubMed  Google Scholar 

  15. Varughese AM, Hagerman N, Townsend ME (2013) Using quality improvement methods to optimize resources and maximize productivity in an anesthesia screening and consultation clinic. Paediatr Anaesth 23(7):597–606

    Article  PubMed  Google Scholar 

  16. Serafini G, Ingelmo PM, Astuto M, Baroncini S, Borrometi F, Bortone L, Ceschin C, Gentili A, Lampugnani E, Mangia G, Meneghini L, Minardi C, Montobbio G, Pinzoni F, Rosina B, Rossi C, Sahillioğlu E, Sammartino M, Sonzogni R, Sonzogni V, Tesoro S, Tognon C, Zadra N (2014) Preoperative evaluation in infants and children: recommendations of the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI). Minerva Anestesiol 80(4):461–469

    CAS  PubMed  Google Scholar 

  17. Sgandurra A, Petrini F (1998) Valutazione e selezione dei pazienti. In: Gullo A (ed) Anestesia Clinica. Springer, Milano, pp 49–60

    Google Scholar 

  18. American Society of Anesthesiologists Task Force on Preanesthesia Evaluation, Pasternak LR, Arens JF, Caplan RA, Connis RT, Fleisher LA, Flowerdew R, Gold BS, Mayhew JF, Nickinovich DG, Rice LJ, Roizen MF, Twersky RS (2012) Practice advisory for preanesthesia evaluation: an updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology 116(3):522–538

    Google Scholar 

  19. Mangia G, Presutti P, Antonucci A, Bianco F, Bonomo R, Ferrari P (2009) Diagnostic accuracy of anesthesiology evaluation timing: the ‘One-Stop Anesthesia’ in pediatric day-surgery. Paediatr Anaesth 19(8):764–769

    Article  PubMed  Google Scholar 

  20. Mangia G, Bianco F, Bonomo R, Di Caro E, Frattarelli E, Presutti P (2011) Willingness to pay for one-stop anesthesia in pediatric day surgery. Ital J Pediatr 37:23

    Article  PubMed Central  PubMed  Google Scholar 

  21. Twersky R, Frank D, Lerovits A (1990) Timing of preoperative evaluation for surgical outpatients-does it matter? Anesthesiology 73:3A

    Article  Google Scholar 

  22. Pasternak LR (2008) Preanesthesia evaluation and testing. In: Beverly KP, Twersky RS (eds) Handbook of ambulatory anesthesia, 2nd edn. Springer, New York, pp 1–23

    Chapter  Google Scholar 

  23. Wittkugel EP, Varughese AM (2006) Pediatric preoperative evaluation – a new paradigm. Int Anesthesiol Clin 44(1):141–158

    Article  PubMed  Google Scholar 

  24. Tagge EP, Hebra A, Overdyk F et al (1999) One-stop surgery: evolving approach to pediatric outpatient surgery. J Pediatr Surg 34:129–132

    Article  CAS  PubMed  Google Scholar 

  25. Astuto M, Disma N, Sentina P et al (2003) One-stop surgery in pediatric surgery. Aspect of anesthesia. Minerva Anestesiol 69:137–144

    CAS  PubMed  Google Scholar 

  26. Ferrari LR (2004) Preoperative evaluation of pediatric surgical patient with multisystem considerations. Anesth Analg 99:1058–1069

    Article  PubMed  Google Scholar 

  27. Rushforth H, Burge D, Mullee M, Jones S, McDonald H, Glasper EA (2006) Nurse-led paediatric pre operative assessment: an equivalence study. Paediatr Nurs 18(3):23–29

    PubMed  Google Scholar 

  28. Varughese AM, Byczkowski TL, Wittkugel EP, Kotagal U, Dean Kurth C (2006) Impact of a nurse practitioner-assisted preoperative assessment program on quality. Paediatr Anaesth 16(7):723–733

    Article  PubMed  Google Scholar 

  29. Section on Anesthesiology and Pain Medicine (2014) The pediatrician’s role in the evaluation and preparation of pediatric patients undergoing anesthesia. Pediatrics 134(3):634–641

    Article  Google Scholar 

  30. Wittkugel E, Varughese A (2015) Development of a nurse-assisted preanesthesia evaluation program for pediatric outpatient anesthesia. Paediatr Anaesth 25(7):719–726

    Article  PubMed  Google Scholar 

  31. Mangia G, Bianco F, Ciaschi A, Di Caro E, Frattarelli E, Marrocco GA (2012) De-hospitalization of the pediatric day surgery by means of a freestanding surgery center: pilot study in the Lazio Region. Ital J Pediatr 38:5

    Article  PubMed Central  PubMed  Google Scholar 

  32. Brennan LJ (1999) Modern day-case anaesthesia for children. Br J Anaesth 83(1):91–103

    Article  CAS  PubMed  Google Scholar 

  33. Patel RI, Hannallah RS (1992) Preoperative screening for pediatric ambulatory surgery: evaluation of a telephone questionnaire method. Anesth Analg 75(2):258–261

    Article  CAS  PubMed  Google Scholar 

  34. Flamm M, Fritsch G, Hysek M, Klausner S, Entacher K, Panisch S, Soennichsen AC (2013) Quality improvement in preoperative assessment by implementation of an electronic decision support tool. J Am Med Inform Assoc 20(e1):e91–e96

    Article  PubMed Central  PubMed  Google Scholar 

  35. London ML, Ladewig PW, Davidson MC, Ball JW, Bindler RC, Cowen KJ (2014) Maternal & child nursing care, 4th edn. Prentice Hall

    Google Scholar 

  36. Bona G, Miniero R (2013) Pediatria pratica. Edizioni Minerva Medica, Torino

    Google Scholar 

  37. Solevåg AL, Eggen EH, Schröder J, Nakstad B (2013) Use of a modified pediatric early warning score in a department of pediatric and adolescent medicine. PLoS One 8(8), e72534

    Article  PubMed Central  PubMed  Google Scholar 

  38. American Academy of Pediatrics. Section on Anesthesiology (1996) Evaluation and preparation of pediatric patients undergoing anesthesia. Pediatrics 98(3 Pt 1):502–508

    Google Scholar 

  39. Patel RI, Hannallah RS (2000) Laboratory tests in children undergoing ambulatory surgery: a review of clinical practice and scientific studies. Ambul Surg 8(4):165–169

    Article  PubMed  Google Scholar 

  40. Meneghini L, Zadra N, Zanette G, Baiocchi M, Giusti F (1988) The usefulness of routine preoperative laboratory tests for one-day surgery in healthy children. Paediatr Anaesth 8(1):11–15

    Article  Google Scholar 

  41. National Collaborating Centre Acute Care (2003) Preoperative test, the use of routine preoperative tests for elective surgery. National Institute for Clinical Excellence (NICE), London

    Google Scholar 

  42. Olson RP, Stone A, Lubarsky D (2005) The prevalence and significance of low preoperative hemoglobin in ASA 1 or 2 outpatient surgery candidates. Anesth Analg 101(5):1337–1340

    Article  CAS  PubMed  Google Scholar 

  43. Hackmann T, Steward DJ, Sheps SB (1991) Anemia in pediatric day-surgery patients: prevalence and detection. Anesthesiology 75(1):27–31

    Article  CAS  PubMed  Google Scholar 

  44. Roy WL, Lerman J, McIntyre BG (1991) Is preoperative haemoglobin testing justified in children undergoing minor elective surgery? Can J Anaesth 38(6):700–703

    Article  CAS  PubMed  Google Scholar 

  45. Maxwell LG, Deshpande JK, Wetzel RC (1994) Preoperative evaluation of children. Pediatr Clin North Am 41(1):93–110

    CAS  PubMed  Google Scholar 

  46. Chee YL, Crawford JC, Watson HG, Greaves M (2008) Guidelines on the assessment of bleeding risk prior to surgery or invasive procedures. British Committee for Standards in Haematology. Br J Haematol 140(5):496–504

    Article  CAS  PubMed  Google Scholar 

  47. Samková A, Blatný J, Fiamoli V, Dulíček P, Pařízková E (2012) Significance and causes of abnormal preoperative coagulation test results in children. Haemophilia 18(3):e297–e301

    Article  PubMed  Google Scholar 

  48. Pajot S, Asehnoune K, Le Roux C, Léturgie C, Surbled M, Bazin V, Lejus C (2009) Evaluation of the haemostasis before a central block in children: what is the French anaesthesiologist’s attitude? Ann Fr Anesth Reanim 28(1):3–10

    Article  CAS  PubMed  Google Scholar 

  49. Chee YL, Greaves M (2003) Role of coagulation testing in predicting bleeding risk. Hematol J 4(6):373–378

    Article  PubMed  Google Scholar 

  50. Scheckenbach K, Bier H, Hoffmann TK, Windfuhr JP, Bas M, Laws HJ, Plettenberg C, Wagenmann M (2008) Risk of hemorrhage after adenoidectomy and tonsillectomy. Value of the preoperative determination of partial thromboplastin time, prothrombin time and platelet count. HNO 56(3):312–320

    Article  CAS  PubMed  Google Scholar 

  51. Watson-Williams EJ (1979) Hematologic and hemostatic considerations before surgery. Med Clin North Am 63(6):1165–1189

    CAS  PubMed  Google Scholar 

  52. von Walter J, Kroiss K, Höpner P, Russwurm W, Kellermann W, Emmrich P (1998) Preoperative ECG in routine preoperative assessment of children. Anaesthesist 47(5):373–378

    Article  Google Scholar 

  53. Quaglini S, Rognoni C, Spazzolini C, Priori SG, Mannarino S, Schwartz PJ (2006) Cost-effectiveness of neonatal ECG screening for the long QT syndrome. Eur Heart J 27(15):1824–1832

    Article  PubMed  Google Scholar 

  54. Knowles R, Griebsch I, Dezateux C, Brown J, Bull C, Wren C (2005) Newborn screening for congenital heart defects: a systematic review and cost-effectiveness analysis. Health Technol Assess 9(44):1–152

    Article  CAS  PubMed  Google Scholar 

  55. Wren C, Reinhardt Z, Khawaja K (2008) Twenty-year trends in diagnosis of life-threatening neonatal cardiovascular malformations. Arch Dis Child Fetal Neonatal 93(1):F33–F35

    Article  CAS  Google Scholar 

  56. Wood RA, Hoekelman RA (1981) Value of the chest X-ray as a screening test for elective surgery in children. Pediatrics 67(4):447–452

    CAS  PubMed  Google Scholar 

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Correspondence to Giovanni Mangia .

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Mangia, G., Patti, C., Presutti, P. (2016). Preoperative Evaluation in Pediatric Anesthesia. In: Astuto, M., Ingelmo, P. (eds) Perioperative Medicine in Pediatric Anesthesia. Anesthesia, Intensive Care and Pain in Neonates and Children. Springer, Cham. https://doi.org/10.1007/978-3-319-21960-8_2

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  • DOI: https://doi.org/10.1007/978-3-319-21960-8_2

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-21959-2

  • Online ISBN: 978-3-319-21960-8

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