Audit on postoperative complications in pediatric patients at the postanesthesia care unit

This is the authors' abstract. We don't add key points for this paper.

Background: Postoperative complications are common in pediatric patients. This clinical problem may be prevalent in resource-limited areas because of shortages in monitoring equipment, oxygen supply, and drugs. The aim of this audit is to assess the magnitude of postoperative complications. Methods: A prospective audit was conducted at the postanesthesia care unit. The audit was collected using a checklist developed based on a literature review. Descriptive statistics were used for data analysis, and the data were presented using frequency and percentage. Result: A total of 63 pediatric patients were included in the audit. There was excellent (≥90%) practice in recording pre-existing medical conditions (92%), continuous monitoring (95.2%), recording initial vital signs (100%), documenting complications, ensuring full awakening (100%), confirming stable vital signs prior to discharge (100%), and providing verbal and written handovers (97.8%). However, there was very poor practice (<50%) in recording vital signs every 15 minutes (15.8%) and documenting pain scores (44.4%). Additionally, the practices of oxygen supplementation (66.7%) and medication administration (74.6%) were relatively low (60–79%). Regarding the incidence of postoperative complications, postoperative pain was the most common adverse event (66.6%), followed by hypothermia (23.8%), delayed awakening (22.2%), postoperative nausea and vomiting (20.6%), oxygen desaturation (19%), emergence agitation (11.1%), bradycardia (6.3%), bronchospasm (1.2%), and arrhythmia (1.2%). Conclusions and recommendations: There are areas of good practice but high complication rates. We suggest that training should be provided for healthcare providers on pediatric pain assessment and management. Moreover, healthcare providers should provide anti-emetic prophylaxis. Furthermore, healthcare providers should provide oxygen for pediatric patients. Finally, healthcare providers should record vital signs every 15 minutes and administer medications in a timely manner.