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Podklady pro výukový seminář "Neonatal perioperative care".

PREOPERATIVE AND POSTOPERATIVE CARE OF THE PEDIATRIC SURGICAL PATIENT AT NICU DEPARTMENT 7C

CARE OF SURGERY PATIENT
- PREOPERATIVE EVALUATION AND PREPARATION
- OPERATION
- POSTOPERATIVE CARE

GOALS OF PREOPERATIVE CARE
-minimalize stress factors
-optimalize operation
-avoid complications
-improve postoperative adaptation

NICU clinical cases
Case no. 1: Patient after omphalocele repair - contrast study for CVC placement
Case no. 2: Patient after AOE repair – primary anastomosis – X-ray control on 2nd postoperative day for ventilatory deterioration following extubation
Case no. 3: Boy 2-mo. old, meconium plug syndrome with spontaneous resolution, discharged home, healthy until…
Case no. 4: Dyspnea after delivery. Transferred to NICU, where X-rayed.
Case no. 5: 3-d. old infant, treated for suspected infection from day 2, bloody stools, spinal tap performed, on day 3 for abdominal distention X-ray study

Neonatal surgery Congenital diseases
•Atresia GIT, biliary atresia, Malrotation, Diaphragmatic hernias, Abdominal wall defects, Lung anomaly

Acquired diseases
•Perinatal trauma, Hernias, Testicular torsion, Ileus, Perforation and inflammation of GIT, NEC, Tumors

Surgery of congenital malformations - complex treatment; Survival in isolated malformation in Motol Hospital; Congenital diaphragmatic hernia – posterolateral, Bochdalek - Czech pathologist Professor Bochdalek in1848.

Perioperative analgesia in children; Postoperative pain management is a crucial task for all doctors treating children in a postoperative setting; Aims:
- to eliminate postoperative pain
- to minimize perioperative stress
- to prevent forming of negative memory imprints
Patophysiology of paediatric perioperative pain;
Drug absorption is decreased in neonates because of
Drug distribution in influenced by
Drug elimination is influenced by
Analgetics overview; Opioids I.; Opioids II.; Non-opioids I.

2nd Faculty of Medicine Official Web Site

General oncology - educational materials

Necessity of complete care for handicaped children. Early diagnosis, therapy, social care, education.