Consideraciones en el paciente pediátrico con síndrome de apnea/hipopnea obstructiva del sueño (SAHOS): desde la fisiopatología al perioperatorio / Considerations in pediatric patients with obstructive sleep apnea/hypopnea syndrome (OSAHS): From physiopathology to the perioperative period

Abstract Introduction: OSAHS is a respiratory disorder with perioperative complications, which increase morbidity and mortality. The characteristics of the pediatric population require a careful perioperative assessment. Objective: This article addresses relevant physiopathology, clinical and paraclinical topics, perioperative treatment and care of pediatric patients with OSAHS. Materials and methods: A literature search was conducted in PubMed and Embase databases using the MeSH terms: sleep apnea syndromes, obstructive sleep apnea, physiopathology, perioperative period, and perioperative care. The titles and/or the abstracts of each of the obtained results were reviewed and 60 articles were finally selected. Results and conclusion: The knowledge of the physiopathology, the adequate preanesthetic assessment and the pertinent request of paraclinical care, allows for the adjustment of the perioperative care and to improve the results of the patient.

Resumen Introducción: El síndrome de apnea/hipopnea obstructiva del sueño (SAHOS) es un trastorno respiratorio con complicaciones perioperatorias que aumentan la morbimortalidad; las características de la población pediátrica hacen necesaria una cuidadosa valoración perioperatoria. Objetivo: Este artículo aborda tópicos relevantes de la fisiopatología, la clínica, paraclínicos, tratamientos y cuidados perioperatorios de los pacientes pediátricos con SAHOS. Materiales y métodos: Se realizó una búsqueda de literatura, en base de datos de Pubmed y Embase, con los términos MESH: Syndromes sleep apnea, Obstructive sleep apnea, Physiopathology, Perioperative Period, Perioperative Care. Se revisaron los títulos y/o resúmenes de cada uno de los resultados obtenidos y se escogieron finalmente 60 artículos. Resultados y conclusión: El conocimiento de la fisiopatología, la adecuada valoración preanestésica y la pertinente solicitud de paraclínicos permiten establecer el ajuste de los cuidados perioperatorios y mejorar los resultados del paciente.

Comparison of bupivaeaine or fentanyl for caudal postoperative analgesia in children / 中华麻醉学杂志

To compare the efficacy and side effects of bupivaeaine(Bup)at two concentrations and fentanyl for caudal analgesia in children. Method:One hundred-fifty children undergoing hernia repair procedures under caudal anesthesia, were randomly assigned to five groups. Group A: 1% lidocaine (Lid), group B: 10% Lid+0.1% Bup, group C: 1% Lid+0.25% Baeup, group D: 1%Lid+0.15%Bup with 2?g?kg~(-1) fentanyl, group E: 1%Lid+0. 25%Bup with 2?g?kg~(-1) fentanyl for caudal analgesia, The degree of pain(LPS), nausea and vomiting (NV) were as sessed at 4, 8, 12 and 24 h after operation. Result: The numbers of LPS