International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2014
Laryngotracheal stenosis and airway surgery--an outcomes based approach.
To review the outcomes of endoscopic, open or a combination of both surgical modalities for laryngotracheal stenosis and establish which factors influence results. ⋯ Both open and endoscopic surgery have a role in laryngotracheal stenosis, and many patients benefit from a combination of both. Ultimately the decision depends on experience of the treating team, social considerations, and institutional capabilities. A multi-centre prospective data collection would be a useful tool to further investigate optimal management approach.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2014
Meta AnalysisKetamine peritonsillar infiltration during tonsillectomy in pediatric patients: An updated meta-analysis.
Peri-operative ketamine peritonsillar infiltration in children can reduce the incidence of postoperative nausea and vomiting (PONV), but its postoperative analgesic time is short. A previous meta-analysis in 2011 was inconclusive due to insufficient data. Consequently, we updated the meta-analysis to verify the role of ketamine peritonsillar infiltration for tonsillectomy in pediatric patients. ⋯ Compared to placebo, ketamine peritonsillar infiltration can relieve postoperative pain within one hour but not at 120 min and reduces analgesic requirement and incidence of PONV. Moreover, there was no difference in the first analgesic time.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2014
Review Case ReportsIatrogenic phenol injury: a case report and review of medication safety and labeling practices with flexible laryngoscopy.
Medication errors can be reduced by following standards in patient identification and medication labeling. We present an investigation of a life-threatening event from medication error: A newborn that received intranasal phenol instead of topical anesthetic prior to flexible laryngoscopy. ⋯ The hospital course was prolonged and included intensive care, delayed oral feeding with enteral support, and the need for several endoscopies. Current standards of medication labeling are reviewed as well as evidence for and against using topical agents for flexible laryngoscopy.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2014
Acetaminophen plus ibuprofen versus opioids for treatment of post-tonsillectomy pain in children.
To determine the efficacy and safety of acetaminophen plus ibuprofen in treatment of post-tonsillectomy pain compared to acetaminophen plus opioids in children. ⋯ Prescription of ibuprofen did not increase the risk of bleeding and did not increase the likelihood of a post-operative ED visit or nurse phone call. Ibuprofen prescription may possibly increase the risk of multiple bleeding episodes, but further prospective studies are needed. Increased age increases the risk of bleeding, ED visits, and nurse phone calls.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2014
Randomized Controlled TrialPre-emptive peritonsillar dexamethasone vs. levobupivacaine infiltration for relief of post-adenotonsillectomy pain in children: a controlled clinical study.
To investigate the effects of the pre-emptive local infiltration of dexamethasone vs. levobupivacaine on postoperative pain and morbidity in pediatric adenotonsillectomy patients. ⋯ Peritonsillar dexamethasone infiltration was more effective than both levobupivacaine and saline in reducing post-tonsillectomy pain. It was proven to be a safe and effective method.