Surgical Procedures, Operative
Conditions
Brief summary
The purpose of this study is to evaluate the quality of outcomes in the Post Anesthesia Care Unit (PACU) at BCH and to identify preoperative demographic and behavioral data as well as intraoperative and anesthetic predictors of adverse PACU outcomes. The investigators hypothesize quality of PACU outcomes will correlate with preoperative demographic and behavioral characteristics as well as intraoperative and anesthetic procedures/techniques. This study will help the investigators improve post anesthetic care quality and create a higher level of satisfaction for patients, family, and health care providers.
Interventions
None listed
Sponsors
Boston Children's Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
6 Months to 30 Years
Healthy volunteers
No
Inclusion criteria
* All patients scheduled for surgery at Boston Children's Hospital ages 6 months to 30 years undergoing the following qualifying surgeries: Genito-Urinary/Urology Department: * Circumcision, Orchidopexy, Hypospadias Repair, Hernia Repair, Cystoscopy, Pyeloplasty, and Ureteral Reimplants or Ureteral Stents. Otolaryngology Department: * Tonsil and/or Adenoid Removal, Tympanostomy, Tympanoplasty, and Mastoidectomy. Orthopaedics Department: * Hip and Knee Arthroscopies, Hardware Removal, and Tendon Lengthening. * Plastic Surgery Department: Alveolar Cleft Repair.
Exclusion criteria
* English as a second language. * \< 6 months, \> 21 or 30 (hip patients only). * Resident of a residential facility or ward of state. * Guardianship status unclear. * Not headed to the PACU post-operatively. * Day of: Projected to arrive in PACU after 3 PM. * Duration of surgery well beyond ordinary for procedure type. * Exceptionally complex medical history.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Significant Pain in PACU | On day of surgery. | Incidence of significant pain defined by pain behavior information from the Faces-Legs-Activity-Cry-Consolability (FLACC) scale, Wong-Baker Faces scale, visual analog scale/numerical scale or adapted numerical rating scale - equal to or more than 5 on a scale from 0 to 10 at any time during the PACU stay. |
| Incidence of Agitation in PACU | On day of surgery. | Incidence of agitation using emergence agitation categorization with Pediatric Agitation Emergence Delirium (PAED) scale equal to or more than 10 on this scale for more than 30 seconds during the recovery period. |
| Incidence of Post-Operative Nausea or Vomiting | On day of surgery. | Post-operative vomiting (POV) will be measured by episodes of vomiting or retching in PACU. This will be a binary outcome - either vomiting/retching occurred or it did not. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Satisfaction of Patients and Families with Post-Operative Care | At two days and two weeks after surgery. | Satisfaction of patients and families with perioperative care, as determined from a three-question satisfaction survey allowing participating families to rate their recovery experience, global surgical experience, and need for further care at another healthcare facility. |
| Post-Hospitalization Behavior Changes | At two days and two weeks after surgery. | Post-hospitalization behaviors changes defined by development of 4 or more behavior changes on the Post Hospitalization Behavior Questionnaire (PHBQ) or development of increased stress levels on the Child PTSD Symptom Scale (CPSS). |
Countries
United States
Outcome results
None listed