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KMID : 0356019930080010053
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Koean Jounral of Critical Care Medicine
1993 Volume.8 No. 1 p.53 ~ p.58
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Anesthesia for Ambulatory Pediatric Patients
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Abstract
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The practice of pediatric ambulatory surgery was first documented by J.H. Nicoll. However, the free-standing surgical center did not develop until 1970 when anesthesiologist Wallace Reed opened the Pheonix Surgicenter. In recent years, ambulatory
surgery has been developed dramatically. Current estimates are that 40 to 60 percent of all surgical procedures could be performed in ambulatory surgical centers. Several factors favor ambulatory surgery rather than the inpatient setting; first,
hospital costs are decreased (about 25~75%), second, it is less disruptive to the patient's personal life, third, the risk of hospital-acquired infection can be significantly decreased. We have analyzed retrospectively the charts of 429 patients
who
were performed general anesthesia for ambulatory surgery, and we obtain better guidance for anesthetic management in pediatric ambulatory surgical patient.
@ES The results were as follows;
@EN 1) The number of patients who were performed general anesthesia for ambulatory surgery from 1987 to 1992 was 429, and it was 3.2% of total surgical procedures with general anesthesia. The number of patients in each year had no difference.
2) The 429 patients consisted of 249 males (58.0%) and 180 females (42.0%). Ages were grouped into 3 categories; <1 year of 51 patients(11.9%), 1~5 years of 286 patients (66.7%) and >6 years of 92 patients(21.4%) with ages ranging from 1 month
to
12
years, mean age 3.7±3.0 years.
3) Departments were grouped into; ophthalmologic (63.9%), dermatologic(31.9%), otolaryngologic(1.9%), plastic(1.2%), urologic (0.8%) and general (0,2%), Most frequent operations were EUA of 117 cases and molluscum extraction of 115 cases.
4) The relations between departments and the length of operation time and anesthesia time; operation times of opthalmologic dermatologic, urologic, otolaryngologic and plastic procedures were 12.1±6.7, 14.9±7.5, 23.8±6.5, 13.6±4.8 and
16.3±4.8
minutes, the mean operation time was 13.2±7.1 minutes and anesthesia times of them were 16.8±6.8, 19.5±8.1, 28.8±6.5, 16.0±4.7 and 21.3±4.8 minutes.
5) The anesthesia procedures performed were grouped into; intravenous anesthesia of 21 cases, inhalation circle system of 324 cases, inhalation Jackson-Ree's system of 84 cases. Operation time according to the anesthesia procedures were
11.0±6.1,
13.4±7.5, 12.8±5.5 minutes, anesthesia time were 16.2±7.5, 18.0±7.8, 17.5±5.9 minutes and mean ages were 4.1±1.9, 4.1±2.2 1.7±1.3 years.
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