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Perioperative mortality in children in a tertiary teaching hospital in Nigeria: a prospective study

World Journal of Pediatric Surgery 2021年第1期4卷 25-31页

作者： Ademola Olusegun Talabi Olugbenga Olalekan Ojo Olurotimi Idowu Aaron oludayo adedapo sowande Folayemi Aramide Faponle Olusanya Adejuyigbe Department of Surgery Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals ComplexIle-lfeOsun StateNigeria Department of Anaesthesia Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals ComplexIle-lfeOsun StateNigeria

Background Perioperative mortality is one of the tools that can help to assess the adequacy of healthcare delivery in a *** audit was conducted to determine the 24-hour,7-day and 30-day perioperative mortality rates and the predictors of mortality in a pediatric surgical *** This was a prospective study of children whose ages ranged from a few hours to 15 years and who were operated on between May 2019 and April *** primary outcome was to determine the incidence of in-hospital perioperative *** A total of 530 procedures were done in 502 *** ages ranged from a few hours to 15 years with a median of 36 *** 24-hour,7-day and 30-day mortality rates were 113.2 per 10000 procedures[95%confidence interval(CI)=40 to 210],207.6 per 10000 procedures(95%CI=110 to 320)and 320.8 per 10000 procedures(95%CI=190 to 470),*** anomalies complicated by postoperative sepsis contributed to death in the majority of *** predictors of mortality were neonatal age group[adjusted odds ratio(AOR)=19.92,95%CI=2.32 to 170.37,p=0.006],higher American Society of Anesthesiologists Physical Status III and above(AOR=21.6,95%CI=3.05 to 152.91,p=0.002),emergency surgery(AOR=17.1,95%CI=5.21 to 60.27,p=0.001),congenital anomalies(AOR=12.7,95%CI=3.37 to 47.52,p=0.001),and multiple surgical procedures(AOR=9.7,95%CI=2.79 to 33.54,p=0.001).Conclusion Perioperative mortality remains high in our institution.

关键词： mortality prospective children

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Comparison of dorsal penile nerve block alone and in combination with lidocaine–prilocaine cream in neonates undergoing circumcision: a randomized controlled study

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World Journal of Pediatric Surgery 2022年第4期5卷 217-222页

作者： Ibukunolu Olufemi Ogundele Chigbundu Collins Nwokoro Tewogbade Adeoye Adedeji Arua Obasi Igwe Collins Chijioke Adumah Ademola Olusegun Talabi Aderibigbe Modupe Shonubi oludayo adedapo sowande Department of Surgery Olabisi Onabanjo University Teaching HospitalSagamuNigeria Department of Chemical Pathology Obafemi Awolowo University Teaching Hospitals ComplexIle-IfeNigeria Department of Surgery Obafemi Awolowo University Teaching Hospitals ComplexIle-IfeNigeria

Background Suboptimal neonatal circumcision analgesia causes a significant stress *** is continued search for more effective analgesia for neonatal *** aimed to determine whether lidocaine–prilocaine cream(LPC)prior to dorsal penile nerve block(DPNB)offers better analgesia than DPNB *** A prospective randomized study of 72 neonates undergoing plastibell circumcision was randomized into two groups of 36 *** I received DPNB alone with 4 mg/kg plain *** II had 1 g LPC applied to the phallus 1 hour before *** cortisol levels were measured 30 min preoperatively and 30 min *** rate(HR)and peripheral arterial oxygen saturation(SpO2)were noted at 30 min preoperatively,after DPNB injection,after excising the prepuce,and at 30 min *** primary outcome measure was change in serum cortisol levels,while secondary outcomes were changes in HR and *** Both groups had increased mean serum cortisol levels,decreased mean SpO2 and increased mean HR from *** rise in mean serum cortisol level was significantly lower in group II(8.09±4.53µg/dL)than that in group I(11.42±7.83µg/dL)(p=0.034).Changes in SpO2 and HR were significantly less in group II than that in group I patients(p<0.05),except for HR changes at 30 min after excision of the prepuce(p=0.086).Conclusion These data suggest that neonates who received LPC prior to DPNB experienced significantly less pain from plastibell circumcision than those who had DPNB alone.

关键词： randomized alone nates

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