The Incidence of and Risk Factors for Postoperative Fever after Cleft Repair Surgery in Children

Liang, Huihong; Zhang, Mei-Xue; Wen, Yuan-Ming; Xu, Xing-Lan; Mao, Zhifeng; She, Ying-Jun; Liu, Pei-Zhen

doi:10.1016/j.pedn.2019.01.009

Cited by 9 publications

(6 citation statements)

References 24 publications

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“…This rate is also similar to previous reports. 16,17 Most cases were transitory and benign. Postoperative fever after 72 hours was observed less frequently and only associated with COVID-19 infection in one case.…”

Section: Discussionmentioning

confidence: 99%

Cleft Lip and Palate Surgery during COVID-19 Pandemic

Rossell-Perry

Gavino-Gutierrez

2021

Plastic and Reconstructive Surgery - Global Open

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Background: The COVID-19 pandemic has caused a negative impact in every sector of life, especially in the health sector. Patients with different medical conditions are suffering delays in their surgical treatments. Cleft lip and palate is a common congenital disease that requires early interdisciplinary attention, and there is uncertainty about the safety of performing its surgical treatment during the COVID-19 pandemic. The objective of this study was to evaluate the safety of a surgical cleft protocol for cleft lip and palate used during the COVID-19 pandemic at a high volume cleft center in Lima, Peru. Methods: This is a comparative study between two groups of patients with nonsyndromic cleft lip and palate who were operated on before and during the COVID-19 pandemic. Data collection was done by evaluation of presurgical condition, and surgical and nonsurgical postoperative outcomes and complications. Results: Significant differences were observed regarding both the age of the patients at the time of the primary surgeries, and surgical times between the two groups. Nonstatistical significant differences were observed between the two groups regarding the presurgical conditions, postoperative outcomes, and complications. Rate of COVID-19 infection was 1.25%. Conclusions: The surgical protocol used for cleft lip and palate repair during the COVID-19 pandemic is a safe method based on the observed postoperative outcomes. However, the COVID-19 pandemic caused delays of the time of the primary cleft lip and palate repair, and its long-term impact should be well evaluated.

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Section: Discussionmentioning

confidence: 99%

Cleft Lip and Palate Surgery during COVID-19 Pandemic

Rossell-Perry

Gavino-Gutierrez

2021

Plastic and Reconstructive Surgery - Global Open

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“…[ 11 , 16 , 18 – 22 ] However, it ranged from 19.2% to 71% after head and neck and other maxillofacial operations in children. [ 23 – 25 ] Some factors can cause postoperative fever in children, including bacteremia, tissue trauma, dehydration, pulmonary atelectasis, drugs such as atropine, and environmental factors like room temperature and the draping of the patient during surgery. Multivariate analysis showed that low nutritional levels were a risk factor for postoperative fever.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical trials have already confirmed a strong correlation between dehydration and fever after general anesthesia. [ 26 ] Liang et al [ 23 ] reported that the method of anesthesia, duration of surgery, and duration of anesthesia were risk factors for postoperative fever in children following cleft lip and palate repair surgery. However, considering the differences in the surgical site, treatment method, and children's age, further studies are necessary to assess whether these factors affect fever after DGA in children with S-ECC.…”

Section: Discussionmentioning

confidence: 99%

Postoperative complications in Chinese children following dental general anesthesia

et al. 2020

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Dental general anesthesia (DGA) is a safe and high-quality restorative and preventive treatment option for children with severe early childhood caries (S-ECC), who require extensive dental treatment and exhibit anxiety and emotional or cognitive immaturity or are medically compromised. However, several postoperative complications have been reported in children under DGA. This study aimed to evaluate and analyze the prevalence of the relevant factors of postoperative complications in healthy Chinese children following DGA to provide a foundation for pre-, intra-, and postoperative overall health management for healthy and disabled children after DGA. A total of 369 systematically healthy Chinese children (36–71 months old) undergoing a DGA were studied. Data were collected on patients’ histories, characteristics, anesthesia, and dental procedures. Parents or caregivers were interviewed before and 72 hours after the procedure. Data were analyzed using logistic regression. Approximately 94.86% of the enrolled children reported one or more complications. The most prevalent complication was postoperative pain (62.70%), followed by weariness, agitation, masticatory problems, drowsiness, oral bleeding, coughing, fever, sore throat, nausea, constipation, epistaxis, vomiting, excitement, and diarrhea. The long duration of the operation was a risk factor for postoperative pain and weariness. A high nutritional status could be a protective factor for postoperative fever. Prolonged operation means complex treatment, such as pulp therapy or extraction. We speculate that the longer the duration is, the more difficult the dental procedures are. The accumulation of discomfort leads to pain. We suspect that children in lower nutritional levels are more likely to suffer from bacteremia or dehydration, resulting in fever. Postoperative pain was the most prevalent complication after the DGA. A decrease in dental procedure duration might reduce the odds of postoperative pain and weariness. A high nutritional status could be a protective factor for postoperative fever. Children with low nutritional status could be more susceptible to postoperative fever.

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“…Another report showed that the method of anesthesia, type of surgery, duration of surgery, and duration of anesthesia were risk factors for postoperative fever in children following cleft lip and palate repair surgery. [ 13 ] During operation in our case, adequate infusion of fluids was administered to prevent dehydration, and the patient’s IV line was taken out due to noncooperation, after ensuring that he was able to drink water sufficiently. We could have avoided the fever-induced-seizure on the day after the operation if we could perform continuous BT measurement, although this was not possible, or by giving instructions to the ward to take his temperature more frequently.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management of a pediatric patient with Dravet syndrome: A case report

Hase

Takuma²,

Hojo³

et al. 2023

Medicine

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Introduction: Dravet syndrome (DS) is a rare and severe myoclonic epilepsy, with onset commonly occurring in infancy. Seizures are triggered by various causes, including fever, bathing, and light stimulus. DS is refractory to drug treatment. Moreover, status epilepticus (SE) can cause serious encephalopathy and epilepsy-related deaths. There are very few reports of general anesthesia in DS patients. Herein, we report our experience with the anesthetic management of a pediatric patient with DS. Patient concerns and diagnoses: A 5-year-old boy (height, 112 cm; weight, 19 kg) was diagnosed with DS through SCN1A genetic testing, which revealed a de novo novel missense mutation. His medical history included drug-resistant epilepsy, developmental delay, and hypotonia. His seizures tended to be triggered daily by a rise in body temperature (BT), bathing, and light stimulus. He could not receive adequate dental treatment due to DS, although he had previously undergone dental treatment under restraint at the pediatric dentistry department of our hospital. Interventions and outcomes: The patient was scheduled for intensive dental treatment under general anesthesia due to noncooperation, and DS-related limitations. By considering the risk posed by elevated BT, seizure-inducing drugs were avoided, and general anesthesia was completed as planned, uneventfully. Although fluctuation of BT occurred during the procedure, it was finally controlled at the end of anesthesia at about the same level as at anesthesia induction. However, small seizures and a single generalized convulsion were observed accompanied by fever on postoperative day 1. The patient was discharged from the hospital without major problems on postoperative day 3, because of detailed planning and close preoperative cooperation with the attending pediatrician. Conclusion: It is essential to pay attention to managing BT and to avoid drugs that induce seizures during anesthesia for patients with DS. Cautious preoperative planning for anesthesia based on evaluation of the patient and rapid postoperative response in collaboration with the attending pediatrician is necessary in case an epileptic seizure occurs.

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The Incidence of and Risk Factors for Postoperative Fever after Cleft Repair Surgery in Children

Cited by 9 publications

References 24 publications

Cleft Lip and Palate Surgery during COVID-19 Pandemic

Cleft Lip and Palate Surgery during COVID-19 Pandemic

Postoperative complications in Chinese children following dental general anesthesia

Anesthetic management of a pediatric patient with Dravet syndrome: A case report

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