Dr Karen Ng Huey Nee

Supervisor: Prof Dr. Chaw Sook Hui

24 January 2025

Objectives: To learn prevention and management of post op apnea in paediatrics

Learning Points:

• Post op apnea is a complication in neonates/young infants (esp those who are premature).
• Reducing risk of apnea and identifying infants at risk of apnea will reduce morbidity and guide clinicians on optimal timing for surgery and intensity of post op monitoring.
• A validated, age‐adjusted morphine dosing regimen should be used for all pediatric patients but particularly for neonates where the dose and dosing interval will need to be altered significantly.
• Dosage of most synthetic opioids should be decreased in neonates during the first two to four weeks of life (and for premature neonates until at least 44 weeks post conceptual age).
• If opioids are indicated for post-operative pain management, it is essential to implement proper monitoring to ensure patient safety and prevent potential complications.

Opiods should be administered for peri operative analgesia whenever it is indicated. However, it is important to identify apnea secondary to opiods. It has to be prevented with proper post op monitoring in relevant nursing wards/ critical care unit. New protocol for monitoring the risk of postoperative apnoea in children should be establised and followed.