Abraham Melvin Alex, Devasia Anup J, George Sajan Philip, George Biju, Sebastian Tunny
Department of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.
Anesth Essays Res. 2019 Jan-Mar;13(1):91-96. doi: 10.4103/aer.AER_5_19.
Children serving as a donor for their siblings will require anesthesia or sedation. In view of shortage of time and space in operating room setting, peripheral blood stem cell (PBSC) harvest is performed as a daycare procedure.
This study aims to find out whether performing PBSC harvest in hematology blood collection area as a daycare procedure is safe or not.
This secondary analysis included 164 pediatric PBSC harvest (154 pediatric donors, of which 10 had repeat harvesting done) donors, performed under anesthesia, in the Department of Hematology, between January 2009 and June 2017.
Donors were examined, informed consent was obtained, and adequate premedications were ensured. Induction was intravenous for cooperative donors or inhalational sevoflurane followed by intravenous maintenance infusion using either face mask or a laryngeal mask airway (LMA). During the procedure, vitals are monitored with a noninvasive monitor. Normal hemodynamics were ensured before transferring the children to the ward.
Statistical analysis was performed using SPSS 16.0 statistical software. Descriptive statistics and frequencies were used for the data description.
A total of 137 donors (median age of 5 years) were induced with sevoflurane and LMA was used in 84 children and face mask in 53. Twenty-seven children cooperated for intravenous induction. Various combinations of propofol, dexmedetomidine, and ketamine were used with respiratory and hemodynamic stability. The median duration of anesthesia was 250 (165-375) min. The recovery from anesthesia was smooth with a median wake-up time of 20 (5-60) min.
This retrospective analysis demonstrates that nonoperating room anesthesia for pediatric age group for PBSC harvest can be safely and successfully accomplished outside the operation room setting by a consultant anesthesiologist.
儿童作为同胞兄弟姐妹的供体需要进行麻醉或镇静。鉴于手术室环境时间和空间有限，外周血干细胞（PBSC）采集作为日间手术进行。
本研究旨在探讨在血液科采血区将PBSC采集作为日间手术进行是否安全。
这项二次分析纳入了2009年1月至2017年6月期间在血液科接受麻醉的164名儿科PBSC采集供体（154名儿科供者，其中10名进行了重复采集）。
对供者进行检查，获得知情同意，并确保给予适当的术前用药。对于配合的供者采用静脉诱导，或对于不配合的供者采用吸入七氟醚诱导，随后使用面罩或喉罩气道（LMA）进行静脉维持输注。在手术过程中，使用无创监测仪监测生命体征。在将儿童转移至病房前确保血流动力学正常。
使用SPSS 16.0统计软件进行统计分析。描述性统计和频率用于数据描述。
共有137名供者（中位年龄5岁）采用七氟醚诱导，84名儿童使用LMA，53名使用面罩。27名儿童配合静脉诱导。使用了丙泊酚、右美托咪定和氯胺酮的各种组合，呼吸和血流动力学稳定。麻醉中位持续时间为250（165 - 375）分钟。麻醉恢复顺利，中位苏醒时间为20（5 - 60）分钟。
这项回顾性分析表明，儿科年龄组的PBSC采集非手术室麻醉可由麻醉科顾问医师在手术室以外的环境安全、成功地完成。
