Risk of General Anesthesia in Pediatric Skin Procedures with Projection on Tumescent Anesthesia

Abdulmajeed Alajlan; Bader M Alhabeeb; Ali M Alhazmi; Osama A Alobaid; Ahmed A Alharthi; Nada I Al-Habib; Ahmed M El-Malky

doi:10.1155/2020/9327152

Risk of General Anesthesia in Pediatric Skin Procedures with Projection on Tumescent Anesthesia

Dermatol Res Pract. 2020 May 30:2020:9327152. doi: 10.1155/2020/9327152. eCollection 2020.

Authors

Abdulmajeed Alajlan¹, Bader M Alhabeeb², Ali M Alhazmi², Osama A Alobaid², Ahmed A Alharthi³, Nada I Al-Habib⁴, Ahmed M El-Malky^{5

6}

Affiliations

¹ Dermatology Department, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.
² Resident Dermatology Department, King Salman Hospital, Riyadh, Saudi Arabia.
³ Saudi Board of Anesthesia, Anesthesia Department, Security Force Hospital (SFH), Riyadh, Saudi Arabia.
⁴ Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia.
⁵ Research Chair of Evidence-Based Healthcare and Knowledge Translation, Deputy Supervisor Morbidity and Mortality Review Unit, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia.
⁶ Public Health and Community Medicine Department, Theodor Bilharz Research Institute, Academy of Scientific Research, Cairo, Egypt.

Abstract

Background: Uses of general anaesthesia in outpatient invasive procedures have increased, especially in dermatology. Being uncooperative, children often require general anaesthesia, since surgical skin operations are mostly painful.

Aim: The purpose of this study is to evaluate the safety, significant adverse events, and the complication rates related to general anaesthesia, when used among pediatric population undergoing skin procedures.

Methods: We conducted a first retrospective cohort study of patient chart review during the period from September 1, 2017 through September 2019. All patients admitted for pediatric skin procedures during this period have participated in our study. We reviewed selected charts to document any unexpected admissions, adverse events, or complications. Surgical outcomes and anaesthesia complications were reviewed by three anesthesiologists. We assessed inter-rater reliability.

Results: A total of 211 procedures were reported for 211 patients with 19 diagnoses. No adverse events related to anaesthesia were recognized, apart from minor complications noticed in twelve patients. The kappa value range is between 0.78 and 1.00 (95% C.I., 0.46809 to 1.00).

Conclusion: Dermatologist and pediatricians can safely do necessary procedures under general anaesthesia with the supervision of pediatric-trained anesthesiologists while considering other safety and risk precautions and the pediatric age group.