Pediatrik Hastaların Preoperatif Değerlendirmesi

Pediatrik anestezide mortalite oranları gelişen anestezik yaklaşımlar ve artan bilgi birikimiyle her ne kadar azalsa da, perioperatif morbiditeyi vurgulayan yayınlar günümüzde hala mevcuttur. Bu hastalarda tam ve eksiksiz bir preoperatif değerlendirme mortalite ve morbidite oranlarının azalmasında kilit basamaklardan birisidir. Her ne kadar anestezi alacak çocukların çoğu sağlıklı olsa da altta yatan hastalıkların erkenden teşhis edilmesi perioperatif süreçte karşılaşılacak komplikasyonları en aza indirger. Yine çocukların anatomik ve fizyolojik farklılıklarının olması da bu hastalara yaklaşımda her zaman göz önünde bundurulmalıdır. Hastaların değerlendirilmesinde çocuk için stres yaratacak her faktör en aza indirgenmelidir. Gerek çocuk gerekse ailesi için ayrı bir stres kaynağı olan rutin testler, anamnez ve fizik muayeneden bağımsız olarak istenmemeli, preoperatif değerlendirmede elde edilen bulgulara yönelik seçici testler uygulanmalıdır. Hastanın temel fizik muayenesi havayolu, solunum sistemi ve kardiyopulmoner sistem değerlendirmesinden oluşur. Bunlar dışında nöromusküler ve endokrin sistem muayeneleri yapılmalı ve mevcut hastalıklarına yönelik hazırlıklı olunmalıdır. Bu derleme çocuk hastaların anestezi öncesi değerlendirmelerinde ve hazırlıklarında dikkat edilmesi gereken hususları vurgulamaya çalışacaktır.

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