Postoperative anaesthetic concerns in children: Postoperative pain, emergence delirium and postoperative nausea and vomiting

• Published in: Indian journal of anaesthesia Vol. 63; no. 9; pp. 763 - 770
• Main Author: Mehrotra, Shikha
• Format: Journal Article
• Language: English
• Published: Belagaum Wolters Kluwer India Pvt. Ltd 01.09.2019; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Acupuncture; Age; Airway management; Alfentanil; Analgesics; Anesthesia; Antiemetic drugs; Bupivacaine; Cardiac arrest; Cardiac arrhythmia; Children; Complications and side effects; Delirium; Dexmedetomidine; Drug dosages; Drug overdose; Drug therapy; Edema; emergence delirium paediatric; Hypoxia; laryngospasm; Narcotics; Nausea; Nonsteroidal anti-inflammatory drugs; Pain; Pain management; Patients; Pediatric anesthesia; Pediatric research; Physiology; postoperative nausea and vomiting; Postoperative pain; Postoperative period; Prophylaxis; Remifentanil; Review; Risk factors; Sufentanil; Surgery; Surgical techniques; Vomiting; India; Antiemetic drugs; laryngospasm; emergence delirium paediatric; dexmedetomidine; postoperative pain; postoperative nausea and vomiting
• ISSN: 0019-5049; 0976-2817; 0976-2817
• DOI: 10.4103/ija.IJA_391_19

The incidence of anaesthetic complications in children is much more than in adults and sometimes with a severe outcome. Patients under one year of age, those with co-morbidities and posted for emergency surgery are at increased risk for morbidities. Sources of information on the risk involved come from institutional audit, closed claim analysis, and large-scale studies of cardiac arrest. A strategy for preventing postoperative nausea and vomiting (PONV), emergence delirium (ED) and postoperative pain should be a part of every anaesthetic plan. A planned multimodal approach should be opted consisting of nonpharmacologic and pharmacologic prophylaxis along with interventions to reduce the baseline risks. The literature in this subject is reviewed extensively to give comprehensive information to postgraduate students about the current understanding of postoperative anaesthetic concerns. Relevant articles from Pub med, review articles, meta-analysis, and editorials were the primary source of information for this article.