Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2005
Case ReportsEarly complication of pediatric central venous cannulation.
We describe a case of hemothorax following central venous catheter (CVC) insertion in an infant. Presumably injury occurred as a result of perforation with the dilator. Strategies to reduce the risk of complications and possible factors influencing the unsatisfactory delay in diagnosis, including the role of 'Fixation Error', are discussed.
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Paediatric anaesthesia · Nov 2005
Pain management in the neonatal intensive care unit: a national survey in Italy.
This study assessed current medical practice in preventative analgesia and sedation for invasive procedures in neonatal intensive care units (NICU) in Italy. ⋯ The need for adequate analgesia is still underestimated. Further information on the safety of analgesics in neonatology is imperative, as is an adequate education of physicians and nurses on the use of pain control guidelines as part of the standard of care in the NICU.
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Paediatric anaesthesia · Nov 2005
Utility of ultrasound-guided central venous cannulation in pediatric surgical patients: a clinical series.
Central venous cannulation can be particularly difficult in pediatric patients. Central line placement is associated with many well-known complications. While ultrasound-guided techniques are well established, the majority of central venous catheters are placed using landmark guidance. This retrospective study compares the safety and efficacy of ultrasound guidance vs landmark guidance in central venous cannulation of pediatric cardiac surgery patients. ⋯ The overall success of internal jugular vein cannulation for pediatric cardiac surgery is significantly improved with the use of ultrasound guidance, without a significant difference in traumatic complications. However, mostly children above 1 year of age or 10 kg of weight experience advantages of ultrasound technique.
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Paediatric anaesthesia · Nov 2005
Randomized Controlled Trial Comparative StudyComparison of morphine and tramadol by patient-controlled analgesia for postoperative analgesia after tonsillectomy in children.
Tramadol is an alternative to other opioids for postoperative pain management. This prospective, randomized, double-blind study was designed to compare the analgesic efficacy of patient-controlled tramadol with patient-controlled morphine for postoperative pain after tonsillectomy in children. ⋯ Intravenous patient-controlled tramadol is an alternative to patient-controlled morphine for postoperative pain relief in children after tonsillectomy. Morphine gave better postoperative pain relief, but was associated with a higher incidence of nausea than tramadol.
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Paediatric anaesthesia · Nov 2005
Case ReportsNeonatal pneumothorax--an unexpected perioperative complication.
We report our experience of three cases of intraoperative pneumothorax in neonatal surgical patients. Following a review of the literature, we discuss possible causes for each case and methods of treatment. We emphasize the need for inclusion of pneumothorax as a cause for cardiorespiratory instability even when no predisposition is identifiable and highlight the need for prompt treatment to prevent serious morbidity and mortality.