Shorter time since inflammatory bowel disease diagnosis in children is associated with lower mental health in parents.

AIM: This study assessed the mental health of parents of children with inflammatory bowel disease (IBD), compared their mental health with age-matched and gender-matched references and examined parental and child predictors for mental health problems. METHODS: A total of 125 mothers and 106 fathers of 125 children with active and inactive IBD from the Swiss IBD multicentre cohort study were included. Parental mental health was assessed by the Symptom Checklist 27 and child behaviour problems by the Strengths and Difficulties Questionnaire. Child medical data were extracted from hospital records. RESULTS: While the mothers reported lower mental health, the fathers' mental health was similar, or even better, than in age-matched and gender-matched community controls. In both parents, shorter time since the child's diagnosis was associated with poorer mental health. In addition, the presence of their own IBD diagnosis and child behaviour problems predicted maternal mental health problems. CONCLUSIONS: Parents of children with IBD may need professional support when their child is diagnosed, to mitigate distress. This, in turn, may help the child to adjust better to IBD. Particular attention should be paid to mothers who have their own IBD diagnosis and whose children display behaviour problems.

Postoperative nausea and vomiting (PONV) in children.

Postoperative nausea and vomiting (PONV) are common and unpleasant complications. The aim of this study was to evaluate possible aetiologies of PONV in children and to formulate measures to reduce its incidence. During four months 780 patients requiring anaesthesia were studied prospectively. Vomiting occurred in 34.4%, nausea in 39.3% of the patients. Patients < 2 years of age and boys > 13 years vomited rarely, whereas girls > 13 years vomited frequently. The use of propofol was associated with a decreased rate of PONV. Administration of drugs for reversal of neuromuscular blockade, postoperative opioids and certain operative procedures were associated with an increased rate of PONV. Patients with a history of motion sickness and or previous PONV also had an increased rate of PONV. The majority of the patients perceived PONV as a very unpleasant experience. Possible measures to reduce its incidence include: administration of prophylactic antiemetic drugs for high-risk patients (3-13 years, girls > 13 years, history of motion sickness and or previous PONV) who are undergoing surgical procedures with a high incidence of PONV. Adjustment of anaesthetic technique as wider use of propofol, NSAIDs or regional analgesia instead of opioids for postoperative pain relief and avoidance of neuromuscular reversal agents if possible.