Risk Evaluation of General Anesthesia in Pediatric Skin Surgeries: A Retrospective Cohort Study in Saudi Arabia

Risk Evaluation of General Anesthesia in Pediatric Skin Surgeries: A Retrospective Cohort Study in Saudi Arabia

Alhabeeb BM¹, Alharthi AA², Nasser Alhazmi AM¹, Alobaid OA¹, Mostafa Al‑Habib NI³, El-Malky AM^4,5*

¹Dermatology Department, King Salman Hospital, Riyadh-Saudi Arabia

²Anesthesia Department, Security Force Hospital (SFH), Riyadh/ Saudi Arabia

³Medical Education Center, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia

⁴Research Chair of Evidence-Based Healthcare and Knowledge Translation, Morbidity and Mortality Review Unit, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia

⁵Public Health and Community Medicine Department, Theodor Bilharz Research Institute, Academy of Scientific Research, Cairo, Egypt

Corresponding Author: Ahmed Mahmoud El-Malky, PhD(C), MPH

Address: Research Chair of Evidence-Based Healthcare and Knowledge Translation, Morbidity and Mortality Review Unit, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia. Public Health and Community Medicine Department, Theodor Bilharz Research Institute, Academy of Scientific Research, Cairo, Egypt. Tel: 00966564495895; Email: aelmalky@ksu.edu.sa

Received date: 19 October 2019; Accepted date: 07 November 2019; Published date: 12 November 2019

Citation: Alhabeeb BM, Alharthi AA, Nasser Alhazmi AM, Alobaid OA, Mostafa Al‑Habib NI, El-Malky AM. Risk Evaluation of General Anesthesia in Pediatric Skin Surgeries: A Retrospective Cohort Study in Saudi Arabia. Asp Biomed Clin Case Rep. 2019 Nov 13;2(3):106-114.

Copyright © 2019 Alhabeeb BM, Alharthi AA, Nasser Alhazmi AM, Alobaid OA, Mostafa Al‑Habib NI, El-Malky AM. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: General Anesthesia; Pediatric; Dermatologic Surgeries; Complications; Adverse Events

Abstract

Background: Use of general anesthesia in outpatient invasive procedures has increased, especially in the field of dermatology. Being uncooperative, children often require general anesthesia. Especially since surgical skin operations are painful and lengthy, dictating the use of general anesthesia.

Aim: The purpose of this study was to evaluate the safety, significant adverse events, and the complication rates related to general anesthesia, when used among pediatric population underwent skin surgeries.

Methods: We conducted a retrospective cohort study in the form of randomly selected patient chart review, with a surgical code in the array of 8,539–16,782 for 2 years. We reviewed registers to document any unexpected admissions, adverse events or complications. Surgical outcomes and anaesthesia complications were reviewed by three anaesthesia consultants. We conducted Inter-rater reliability test analysis and per cent agreement to determine the level of agreement between raters.

Results: A total of 211 procedures were reported for 211 patients with 19 diagnoses. No adverse events related to anesthesia were recognized in any of those selected patients, apart from minor complications noticed in twelve patients (P value<0.03). Kappa value range between 0.78-1.00 (95% CI, 0.46809 to 1.00).

Conclusion: In case of proper deploying of staff experience, appropriateness of choice of surgical procedure, patient selection, and modern technology as non-dependent confounding variables. Pediatric-trained anesthesiologists can safely use general anaesthesia in dermatological invasive procedures without significant complications.