Khan Ausaf A, Raza Durriya, Qamar-Ul-Hoda Muhammad
Anaesthesiology, Aga Khan University Hospital, Karachi, PAK.
Cureus. 2022 Feb 17;14(2):e22347. doi: 10.7759/cureus.22347. eCollection 2022 Feb.
Preoperative period is a stressful event, especially for paediatric patients undergoing surgery. Stress may lead to the development of perioperative maladaptive behaviour, activation of stress responses, and susceptibility to postoperative infections. To alleviate preoperative stress, the use of a multimodal approach including preoperative pharmacological premedication in the ward is recommended. We conducted an observational study to determine the frequency of prescribing and administering premedication in paediatric surgical patients.
This three-month retrospective observational study was conducted in the main operating room of the Aga Khan University Hospital, Karachi, from October to December 2014. It included all paediatric patients (aged 1-16 years) coming for elective surgery. Patients' preoperative forms and medical records were reviewed, and data recorded for written orders of premedication and the timing of administration of the premedication drug in the inpatient ward/surgical day care ward. A p-value <0.05 was considered statistically significant.
This study included 125 paediatric patients. Premedication was not prescribed to 40% (50/125) patients. In these patients, drug and dose were properly mentioned in 98.7% (74/75) of cases while the route and time of administration were not mentioned in 26.6% and 12% prescription orders, respectively. The premedication drug was administered in 67 out of 75 patients (89.3%) by ward nurses as per prescription. The administration of premedication was documented in 95.5% patients, but the time was missing in 46.3% of cases.
A significant number of patients were not prescribed preoperative premedication by the anaesthetist. Moreover, the route and timing of administration of drug were not mentioned especially in cases when premedication was prescribed in the wards.
术前阶段是一个压力事件，尤其对于接受手术的儿科患者而言。压力可能导致围手术期适应不良行为的发生、应激反应的激活以及术后感染的易感性。为减轻术前压力，建议采用多模式方法，包括在病房进行术前药物预处理。我们进行了一项观察性研究，以确定儿科手术患者中开具和给予预处理药物的频率。
这项为期三个月的回顾性观察性研究于2014年10月至12月在卡拉奇阿迦汗大学医院的主手术室进行。研究纳入了所有前来接受择期手术的儿科患者（年龄1 - 16岁）。查阅了患者的术前表格和病历，并记录了预处理药物的书面医嘱以及在住院病房/手术日间护理病房给予预处理药物的时间。p值<0.05被认为具有统计学意义。
本研究纳入了125名儿科患者。40%（50/125）的患者未开具预处理药物。在这些患者中，98.7%（74/75）的病例正确提及了药物和剂量，而分别有26.6%和12%的处方医嘱未提及给药途径和时间。75名患者中有67名（89.3%）由病房护士按处方给予了预处理药物。95.5%的患者记录了预处理药物的给予情况，但46.3%的病例未记录时间。
相当数量的患者未由麻醉师开具术前预处理药物。此外，尤其是在病房开具预处理药物的情况下，未提及药物的给药途径和时间。
