Skip to main content

Preoperative Assessments in Pediatric Surgery

  • Living reference work entry
  • First Online:
  • 594 Accesses

Abstract

Preoperative assessment has been largely influenced by the evolution and popularity of day case surgery, which has been shown to have major advantages over inpatient surgery (Sadler et al. Ann R Coll Surg Engl. 1992;74(2):130–3; Suhonen et al. Int J Nurs Pract. 2007;13:121–29). Pioneering work in the development of day surgery can be attributed to a Scottish pediatric surgeon, James Nicholl, who performed 460 surgeries for harelip and cleft palate in the 1900s. He considered children were more safely nursed at home rather than in the hospital environment (Nicoll and Spina Bifida. Glasgow Med J. 1902;58:12–9). Now, the majority of pediatric elective surgery is performed on a day case basis, and therefore pre-assessment is essential for this service to perform efficiently and effectively. Fundamental to the success of these initiatives is a clear, comprehensive system that relies on a thorough preoperative evaluation tailored to identifying operative risk with access to appropriate investigative modalities and suitably trained staff. However, there are some unique situations in pediatric surgery that require a different approach to preoperative assessment, such as the work-up of a neonate requiring surgery. These aspects of preoperative assessment, and others, will be discussed in detail in this chapter.

This is a preview of subscription content, log in via an institution.

References

  • Abitbol CL, DeFreitas MJ, Strauss J. Assessment of kidney function in preterm infants: lifelong implications. Pediatr Nephrol. 2016;4. [Epub ahead of print]

    Google Scholar 

  • Alfirevic Z, Neilson JP. Antenatal screening for Down’s syndrome. BMJ. 2004;329(7470):811–2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Association of Paediatric Anaesthetists of Great Britain and Ireland Guidelines. The timing of vaccination with respect to anaesthesia and surgery. The timing of vaccination with respect to anaesthesia and surgery (cited 2013). Available from: http://www.apagbi.org.uk/.

  • Avery GB, et al. Avery’s neonatology: pathophysiology & management of the newborn. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 1748. p. xviii.2005

    Google Scholar 

  • Barrington KJ, Finer NN. Inhaled nitric oxide for preterm infants: a systematic review. Pediatrics. 2007;120(5):1088–99.

    Article  PubMed  Google Scholar 

  • Baudouin L, Bordes M, Merson L, Naud J, Semjen F, Cros AM. Do adult predictive tests predict difficult intubation in children? Eur J Anaesthesiol June 2006;23:163

    Google Scholar 

  • Bell EF, et al. The effects of thermal environment on heat balance and insensible water loss in low-birth-weight infants. J Pediatr. 1980;96(3 Pt 1):452–9.

    Article  CAS  PubMed  Google Scholar 

  • Brady MC, Kinn S, Ness V, O’Rourke K, Randhawa N, Stuart P. Preoperative fasting for preventing perioperative complications in children. Cochrane Database Syst Rev. 2009;(4):CD005285.

    Google Scholar 

  • Clark K, Voase R, Fletcher IR, Thomson PJ. Improving patient throughput for oral day case surgery. The efficacy of a nurse-led pre-admission clinic. Ambul Surg. 1999;7(2):101–6.

    Article  Google Scholar 

  • Cohen MM, Cameron CB. Should you cancel the operation when a child has an upper respiratory tract infection? Anesth Analg. 1991;72(3):282–8.

    Article  CAS  PubMed  Google Scholar 

  • Cole T, Bellizzi M, Flegal K, Dietz W. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Engle W, the Committee on Fetus and Newborn. Surfactant-replacement therapy for respiratory distress in the preterm and term neonate. Pediatrics. 2008;121(2):419–32.

    Article  PubMed  Google Scholar 

  • Folkerts G, Busse WW, Nijkamp FP, et al. Virus-induced airway hyper responsiveness and asthma. Am J Respir Crit Care Med. 1998;157:1708–20.

    Article  CAS  PubMed  Google Scholar 

  • Ford JW. Neonatal ECMO: current controversies and trends. Neonatal Netw. 2006;25(4):229–38.

    Article  PubMed  Google Scholar 

  • Frank J, Jacobe K. Evaluation and management of heart murmurs in children. Am Fam Physician. 2011;84(7):793–800.

    PubMed  Google Scholar 

  • Friis-Hansen B. Water distribution in the foetus and newborn infant. Acta Paediatr Scand Suppl. 1983;305:7–11.

    Article  CAS  PubMed  Google Scholar 

  • Hey EN. The relation between environmental temperature and oxygen consumption in the new-born baby. J Physiol. 1969;200(3):589–603.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hirata GI, Medearis AL, Platt LD. Fetal abdominal abnormalities associated with genetic syndromes. Clin Perinatol. 1990;17(3):675–702.

    CAS  PubMed  Google Scholar 

  • Knox M, Myers E, Wilson I, Hurley M. The impact of pre-operative assessment clinics on elective surgical case cancellations. Surgeon. 2009;7(2):76–8.

    Article  CAS  PubMed  Google Scholar 

  • Laptook AR, Watkinson M. Temperature management in the delivery room. Semin Fetal Neonatal Med. 2008;13(6):383–91.

    Article  PubMed  Google Scholar 

  • Leal AJ, Tannuri AC, Tannuri U. Mechanical bowel preparation for esophagocoloplasty in children: is it really necessary? Dis Esophagus. 2013;26(5):475–8.

    Article  CAS  PubMed  Google Scholar 

  • Lee, et al. A systematic review (meta-analysis) of the accuracy of the mallampati tests to predict the difficult airway. Anesth Analg. 2006;102:1867–78.

    Article  PubMed  Google Scholar 

  • Maisels MJ. Jaundice, Neonatology, A. GB. 2005, Lippincott Williams and Wilkins: Philidelphia. 768–847.

    Google Scholar 

  • Nicoll JH. Spina Bifida; its operative treatment amongst outpatients. Glasg Med J. 1902;58:12–9.

    Google Scholar 

  • Perioperative Fasting in Adults and Children. An RCN guideline for the multidisciplinary team. November 2005 (cited 2013 June 23). Available from: http://www.rcn.org.uk/.

  • Philippart AI, Sarnaik AP, Belenky WM. Respiratory support in pediatric surgery. Surg Clin North Am. 1980;60(6):1519–32.

    Article  CAS  PubMed  Google Scholar 

  • Pollard JB, Olson L. Early outpatient preoperative anesthesia assessment: does it help to reduce operating room cancellations? Anesth Analg. 1999;89(2):502–5.

    CAS  PubMed  Google Scholar 

  • Preoperative Tests. The use of routine preoperative tests for elective surgery. NICE guidance CG3. Developed by the National Collaborating Centre for Acute Care. June 2003. Available from: http://www.nice.org.uk/.

  • Pre-procedure Pregnancy Checking in Under 16s: Guidance for Clinicians. Report of an expert working group convened by: Royal College of Paediatrics and Child Health, Association of Paediatric Anaesthetists of Great Britain and Ireland, Children’s Surgical Forum, British Association of Paediatric Surgeons. November 2012. (cited 2013 June 22). Available from: http://www.rcpch.ac.uk/.

  • Prophylaxis against infective endocarditis. NICE guideline 64. Developed by the Centre for Clinical Practice at NICE. March 2008 (cited 2013 June 23). Available from: http://www.nice.org.uk/.

  • Puri P, Gillick J. Preoperative assessment. In: Puri P, editor. Newborn surgery. 3rd ed. London: Hodder Arnold London; 2011. p. 91–104.

    Chapter  Google Scholar 

  • Sadler GP, Richards H, Watkins G, Foster ME. Day-case paediatric surgery: the only choice. Ann R Coll Surg Engl. 1992;74(2):130–3.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Saltzman DA, Johnson EM, Feltis BA, et al. Surgical experience in patients with cystic fibrosis: a 25-year perspective. Pediatr Pulmonol. 2002;33(2):106–10.

    Article  PubMed  Google Scholar 

  • Serrurier K, Liu J, Breckler F, Khozeimeh N, Billmire D, Gingalewski C, Gollin G. A multicenter evaluation of the role of mechanical bowel preparation in pediatric colostomy takedown. J Pediatr Surg. 2012;47(1):190–3.

    Article  PubMed  Google Scholar 

  • Short JA, Malik D. Preoperative assessment and preparation for anaesthesia in children. Anaesth Intensive Care Med. 2009;10(10):489–94.

    Article  Google Scholar 

  • Silverman WA, Sinclair JC. Temperature regulation in the newborn infant. N Engl J Med. 1966;274(3):146–8.

    Article  CAS  PubMed  Google Scholar 

  • Skolnick ET, Vomvolakis MA, Buck KA. A prospective evaluation of children with upper respiratory infections undergoing a standardized anesthetic and the incidence of respiratory events (abstract). Anesthesiology. 1998;89:A1309.

    Article  Google Scholar 

  • Statter MB. Fluids and electrolytes in infants and children. Semin Pediatr Surg. 1992;1(3):208–11.

    CAS  PubMed  Google Scholar 

  • Suhonen RA, Iivonen MK, Välimäki MA. Day-case surgery patients’ health-related quality of life. Int J Nurs Pract. 2007;13:121–9.

    Article  PubMed  Google Scholar 

  • Tabibi A, Simforoosh N, Basiri A, Ezzatnejad M, Abdi H, Farrokhi F. Bowel preparation versus no preparation before ileal urinary diversion. Urology. 2007;70(4):654–8.

    Article  PubMed  Google Scholar 

  • Tait AR, Malviya S. Anesthesia for the child with an upper respiratory tract infection: still a dilemma? Anesth Analg. 2005;100(1):59–65.

    Article  PubMed  Google Scholar 

  • Tait A, Voepel-Lewis T, Burke C, Kostrzewa A, Lewis I. Incidence and risk factors for perioperative adverse respiratory events in children who are obese. Anesthesiology. 2008;108:375–80.

    Article  PubMed  Google Scholar 

  • Varughese AM, Byczkowski TL, Wittkugel EP, Kotagal U, Dean KC. Impact of a nurse practitioner-assisted preoperative assessment program on quality. Paediatr Anaesth. 2006;16(7):723–33.

    Article  PubMed  Google Scholar 

  • Venous thromboembolism: reducing the risk. Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital. NICE clinical guideline 92. Developed by the National Collaborating Centre for Acute and Chronic Conditions (cited 2013 June 22) Available from: http://www.nice.org.uk/.

  • Victor D, Burek C, Corbetta JP, Sentagne A, Sager C, Weller S, et al. Augmentation cystoplasty in children without preoperative mechanical bowel preparation. J Pediatr Urol. 2012;8(2):201–4.

    Article  PubMed  Google Scholar 

  • Vowles RH, Jefferis AF, Smith C. An assessment clinic for routine paediatric otolaryngological surgery. Ann R Coll Surg Engl. 1997;79(3 Suppl):103–6.

    CAS  PubMed  Google Scholar 

  • Walther-Larsen S, Rasmussen IS. The former preterm infant and risk of post-operative apnoea: recommendations for management. Acta Anaesthesiol Scand. 2006;50(7):888–93.

    Article  CAS  PubMed  Google Scholar 

  • Wille-Jørgensen P, Guenaga KF, Matos D, Castro AA. Pre-operative mechanical bowel cleansing or not? An updated meta-analysis. Color Dis. 2005;7(4):304–10.

    Article  Google Scholar 

  • World Health Organisation. Obesity: preventing and managing the global epidemic. Report of a WHO consultation, Geneva, 3–5 Jun 1997. Geneva: WHO; 1998.

    Google Scholar 

  • Zuckerberg AL, Maxwell LG. Chapter 62, Preoperative assessment (cited 2013 May 30). In: McInerny TK, Adams HM, editors. American Academy of Pediatrics Textbook of Pediatric Care. American Academy of Pediatrics, 2008, USA. Available from: https://www.pediatriccareonline.org/pco/ub/view/AAP-Textbook-of-Pediatric-Care/.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Linda Stephens .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer-Verlag GmbH Germany

About this entry

Cite this entry

Stephens, L., Gillick, J. (2016). Preoperative Assessments in Pediatric Surgery. In: Puri, P. (eds) Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38482-0_24-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-38482-0_24-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38482-0

  • Online ISBN: 978-3-642-38482-0

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics