Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2006
ReviewUltrasonographic guidance in pediatric regional anesthesia. Part 2: techniques.
The benefits of regional anesthesia are well documented. The downsides of such techniques have been a significant failure rate and a potential for serious complications. Nearly, all regional blocks were first described as essentially 'blind' techniques. ⋯ Improved understanding of sonographic anatomy should lessen both the failure rate and the possibility of incurring serious complications. Natural caution has dictated that only a selection of blocks used in adults has been commonly used in pediatric practice, but with the aid of US, the repertoire of blocks for infants and children may be widened. The second part of this review will concentrate on the practice of both peripheral and central blocks.
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Paediatric anaesthesia · Nov 2006
Randomized Controlled Trial Comparative StudyEmergence agitation in preschool children: double-blind, randomized, controlled trial comparing sevoflurane and isoflurane anesthesia.
This randomized, double-blind controlled trial was conducted to determine whether the association of sevoflurane for induction and isoflurane for anesthesia maintenance resulted in a lower incidence of postoperative agitation compared with sevoflurane as single agent. ⋯ The association of sevoflurane for induction and isoflurane for maintenance produced significant less postoperative agitation in preschool children receiving regional anesthesia during subumbilical surgery compared with sevoflurane for induction and maintenance.
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Toxic megacolon is a life-threatening complication of ulcerative colitis (UC) characterized by systemic toxicity, loss of blood per rectum and severe pain. Pain management is challenging in these patients because nonsteroidal anti-inflammatory drugs may exacerbate bleeding and opioids are contraindicated because they adversely affect bowel peristalsis causing an increased risk of colonic perforation. ⋯ We have demonstrated the safe and effective use of ketamine analgesia in children with toxic megacolon, a condition in which the child is in severe pain and morphine is contraindicated.
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Paediatric anaesthesia · Nov 2006
Intraoperative and postoperative risk factors for prolonged mechanical ventilation after pediatric cardiac surgery.
Early extubation after cardiac surgery in children is feasible; however, predictors of prolonged mechanical ventilation (MV) should be recognized as soon as possible. ⋯ Causes of MV after surgery are heterogeneous, vary with time, and have variable impact on the duration of MV.
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Paediatric anaesthesia · Nov 2006
Case ReportsAnesthesia management for the child with Sanjad-Sakati syndrome.
Sanjad-Sakati syndrome (SSS) is a rare genetic disorder characterized by congenital hypoparathyroidism, hypocalcemia and hyperphosphatemia, seizures, severe intrauterine and postnatal growth failure, dwarfism, mental retardation, dysmorphic features including retromicrognathia and abnormal dentition and increased susceptibility to infection. It is mainly confined to children in the Middle-East countries. We report the anesthesia management of a 12-year-old boy with SSS for dental treatment, and discuss the anesthesia implications of this disorder.