Preoperativna procena rizika u pedijatrijskoj anesteziji

Abstract

In general pediatric surgical population, the incidence of perioperative 30-day mortality is low. A child's physical status at the time of elective surgery and the presence of comorbidities can notably impact the perioperative risk. In order to provide quality care, preoperative evaluation should be undertaken in a timely and thorough manner. In preoperative period, it is highly important to be able to identify the patients who are at a higher risk, with the premise that early identification of these patients will allow for additional care to be provided, thereby minimizing possible complications. The main objectives of adequate preoperative assessment are to evaluate patients' readiness for the procedure, optimize patients' health status before surgery, reduce surgical morbidity, and help patients regain their usual functions postoperatively. Routine prescription of additional tests in children should be replaced by selective and rational prescriptions, based on the patients' history and performed clinical evaluation. Surgical and anesthetic complications can have adverse effects on patients' health, and they have also been proven to be associated with increased inpatient and postoperative costs. Each member of the surgical team plays a vital role in the safe care of pediatric patients. Well known risk factors for critical events in the perioperative period in pediatric population are as follows: ASA physical status, age, emergency surgery, and the existence of an underlying disease. This review highlights potential risks encountered in children and directs preoperative assessment towards selecting essential tests based on identified individual risk factors.