1998 Volume 12 Issue 3 Pages 254-261
It is known that allergic children have a higher incidence of perioperative complications than general children, and perioperative complications are thus more likely to be found in the allergic children. Although the factors that cause perioperative complications are so complex and analysis is difficult, we focused on which department among the Pediatric Department, Surgical Department, and the Anesthetic Department was most closely related to their occurrence, and studied improvement methods. Problems in the Pediatric Department that were pointed out included a lack of cooperation between outpatient and inpatient pediatricians, inconsistent perioperative management policies, and a lack of participating allergosis specialists. In the Surgical Department, further improvements were needed in the evaluation of asthmatic severity and preoperative questionnaires method of allergic history. In the Anesthetic Department, issues for consideration were the administration route of premedication and method to assure the airway.
The following countermeasures were considered:
(1) introducing a perioperative management manual for allergic children in accordance with the situation of the facility and to increase knowledge consistently,
(2) notifying information about surgical risks with bronchial asthma complications to surgeons in charge when surgery is planned and starting preoperative management of bronchial asthma at the earliest stage, and
(3) active cooperation of pediatrician in charge with the Anesthetic Department for preoperative evaluation and anesthetic method.
These three points were considered to be important.
