PAEDIATRIC DAY CASE SURGERY: 3 YEARS EXPERIENCE AT PRIVATE MEDICAL CENTRE

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Abstract

ABSTRACT
Objective: To know the feasibility of day case surgery in pediatric surgical cases in terms of cost effectiveness, less
hospital stay, utilization of hospital resources and parents acceptability.
Materials and methods: This prospective descriptive study was conducted in two private medical centers over a period
of three years from April 2012 to April 2014. All paediatric patients from neonatal age to 15 years of age and those who
fulfilled the inclusion criteria of the study were included in the study. After explaining the whole protocol of the day case
surgery, benefits versus risks of the procedure, informed written consent were taken from the parents. All the parents
were interviewed, detail history taken and a thorough physical examination carried out .Parents were instructed for nil
by mouth before surgery and after surgery before leaving the hospital. The parents were briefed about post-operative
care at home like feeding, ambulation and use of analgesics. All operations were carried out by same surgeon. After
surgery and recovery from anesthesia these patients were observed till fully conscious and alert. A contact telephone
number was also provided to the family for any difficulty or emergency. Follow up schedules were on 10th post op day
and whenever needed in case of any emergency. Statistical analysis was made by spss version 20.
Results: A total number of 376 patients were studied during study period. Male to female ratio was 3.5:1.Congenital
inguinal hernia and hydrocele were the most frequent indications 58.5 %( 220) for surgery followed by undescendant
testes 8 %( 30) and bleeding per rectum 6 %( 24). Majority of the parents were satisfied with the patient post operative
management at home and only 5.3% parents contacted the primary surgeon for any patient related concern on
telephone .Patient irritability due to pain was the most frequent problem for primary surgeon contact . Mild superficial
skin infection were the most frequent complication noted on follow up visits .No mortality noted during study period
and a single patient re admission and re examination under general anesthesia for bleeding per rectum secondary to
spontaneously avulsed rectal polyp were noted . Overall parental satisfaction was 88% and cost effectiveness was 67%
in day care surgery. Decreased nursing care costs, doctor visits and hospital resources utilization were significantly

Authors: 
Muhammad Uzair1
Muhammad Khan Wazir2
Riaz Ahmed Khan Afridi1
Fazle Ghani
, Mohammad Ishaq
Mussarat Hussain3

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