Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2006
Randomized Controlled TrialDexmedetomidine decreases emergence agitation in pediatric patients after sevoflurane anesthesia without surgery.
The purpose of the present study was to determine whether prophylactic use of 1 microg x kg(-1) dexmedetomidine affected the incidence of emergence agitation (EA) after sevoflurane based anesthesia without surgery in children. ⋯ We concluded that a 1 microg x kg(-1) dose of i.v. dexmedetomidine reduces EA after sevoflurane anesthesia in children undergoing MRI.
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Paediatric anaesthesia · Jul 2006
Case ReportsBilateral monitoring of cerebral oxygen saturation results in recognition of aortic cannula malposition during pediatric congenital heart surgery.
Congenital heart surgery is associated with a 2-25% reported incidence of neurological complication. Near-infrared spectroscopy (NIRS) can detect changes in regional cerebral saturation index (rSO2i) during cardiac surgery. ⋯ We report a case in which bilateral NIRS monitoring detected an abrupt decrease in rSO2i (right greater than left) after initiation of bypass without abnormalities detected by standard monitors. This resulted in prompt surgical intervention that restored rSO2i, potentially preventing neurological injury.
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Paediatric anaesthesia · Jul 2006
Impact of a nurse practitioner-assisted preoperative assessment program on quality.
The anesthesia manpower shortage in the last few years in the US has limited many hospital pediatric surgical services. We sought to meet an increasing surgical caseload, while providing safe, timely and patient-centered care by instituting a nurse practitioner-assisted preoperative evaluation (NPAPE) program. The strategic goal of this program was to shift anesthesiologists from the preanesthesia clinic to the operating room (OR), while maintaining the quality of preoperative care. Our study sought to evaluate the quality of the NPAPE program. ⋯ Our study revealed that within a year of its implementation, the NPAPE program maintained patient safety, timeliness, and a high level of parent satisfaction as well as increased staff satisfaction, while shifting two anesthesiologists to the OR. A NP-assisted preoperative evaluation program can offer operational advantages without compromising care.