POST OPERATIVE MANAGEMENT:

All patients, unless otherwise indicated should be transported to the recovery room in a lateral position, to help maintain the airway. They should receive supplemental oxygen until awake & have basic parameters of pulse & saturation monitored. Patients may be kept warm either by use of overhead radiant warmers or warm air blankets, or be nursed in an incubator.

Infants less than 44 weeks post-conceptional age are prone to apneic spells post general anaesthesia & should be monitored closely for such events.

POST OPERATIVE PAIN RELIEF:

This starts in the operating theatre. Pain relief for many routine paediatric surgical procedures can be achieved with a regional block e.g. penile block for circumcisions, ilioinguinal nerve block for herniotomies, caudals for hypospadias repairs. Those for major abdominal surgery can receive lumber /thoracic epidurals and older children are very amenable to PCA.

If the block given at the beginning of the procedure does not appear to be working, it may be repeated at the end of operation, provided that the maximum dose of local anaesthesia has not been exceeded. Otherwise, pain relief has to be given in the form of opiates.

A child crying in the recovery room may be doing so for various reasons: pain, cold, discomfort from restrictive dressing, hunger, thirst or fear of strangers and strange environment. Usually pain is evident by behaviour of the child e.g. knee flexion, pulling at operated site, not being comforted by parental presence etc. Older children may be able to inform staff of their needs. Infants may require more patience in eliminating possible reasons for crying. A traumatic, screaming induction may result in a crying child at recovery

Last created on 06-03-2002
Last submitted on 01-07-2006