Enhancing recovery after minimally invasive repair of pectus excavatum.
Pediatr Surg Int
; 33(10): 1123-1129, 2017 Oct.
Article
en En
| MEDLINE
| ID: mdl-28852843
ABSTRACT
PURPOSE:
There are variations in the perioperative management of patients who undergo minimally invasive repair of pectus excavatum (MIRPE). The purpose is to analyze the change in resource utilization after implementation of a standardized practice plan and describe an enhanced recovery pathway.METHODS:
A standardized practice plan was implemented in 2013. A retrospective review of patients who underwent MIRPE from 2012 to 2015 was performed to evaluate the trends in resource utilization. A pain management protocol was implemented and a retrospective review was performed of patients who underwent repair before (2010-2012) and after (2014-2015) implementation.RESULTS:
There were 71 patients included in the review of resource utilization. After implementation, there was a decrease in intensive care unit length of stay (LOS), and laboratory and radiologic studies ordered. There were 64 patients included in the pain protocol analysis. After implementation, postoperative morphine equivalents (3.3 ± 1.4 vs 1.2 ± 0.5 mg/kg, p < 0.01), urinary retention requiring catheterization (33 vs 14%, p = 0.07), and LOS (4 ± 1 vs 2.8 ± 0.8 days, p < 0.01) decreased.CONCLUSION:
The implementation of an enhanced recovery pathway is a feasible and effective way to reduce resource utilization and improve outcomes in pediatric patients who undergo minimally invasive repair of pectus excavatum.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Cuidados Posoperatorios
/
Procedimientos Quirúrgicos Mínimamente Invasivos
/
Manejo del Dolor
/
Tórax en Embudo
Tipo de estudio:
Guideline
/
Observational_studies
Límite:
Adolescent
/
Child
/
Humans
Idioma:
En
Revista:
Pediatr Surg Int
Asunto de la revista:
PEDIATRIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos