European journal of anaesthesiology
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Fibrinogen supplementation is increasingly recommended with the use of rotational thromboelastometry (ROTEM). However, data regarding the paediatric population are sparse. ⋯ Post-CPB plasma fibrinogen concentration significantly influences blood loss in children undergoing cardiac surgery. A fibrinogen concentration of at least 1.5 g l or a MCF of at least 3 mm should accurately predict excessive blood loss in cardiac surgery children. Further prospective trials are needed to assess the effect of fibrinogen supplementation on postoperative blood loss in this population.
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Regional anaesthesic techniques are commonly used for the management of pain following lower abdominal surgery in children. The transversus abdominis plane (TAP) block has shown promise for perioperative analgesia, but data on the optimal dose regimen are limited. ⋯ As part of a multimodal analgesia strategy, ultrasound-guided TAP block with 0.2 ml kg(-1)of 0.2% levobupivacaine provides successful peroperative analgesia in 95% of children who underwent herniorrhaphy.