Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2007
Case ReportsAnaphylactic shock in a beta-blocked child: usefulness of isoproterenol.
Like adults, children taking beta-blockers are at risk for serious hemodynamic instability in case of anaphylaxis. We report a case of severe bradycardia associated with anaphylactic shock after aprotinin in a beta-blocked child, which was resistant to intravenous epinephrine and vascular filling but was treated successfully with isoproterenol.
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Paediatric anaesthesia · Sep 2007
GuidelineConsensus guidelines for sustained neuromuscular blockade in critically ill children.
The United Kingdom Paediatric Intensive Care Society Sedation, Analgesia and Neuromuscular Blockade Working Group is a multidisciplinary expert panel created to produce consensus guidelines on sedation, analgesia and neuromuscular blockade in critically ill children and forward knowledge in these areas. Neuromuscular blockade is recognized as an important element in the care of the critically ill and adult clinical practice guidelines in this area have been available for several years. However, similar clinical practice guidelines have not previously been produced for the critically ill pediatric patient. ⋯ Multidisciplinary consensus guidelines for maintenance neuromuscular blockade in critically ill children (excluding neonates) have been successfully produced and are supported by levels of evidence. The Working Group has highlighted the paucity of high quality evidence in these important clinical areas and this emphasizes the need for further randomized clinical trials in this area.
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Paediatric anaesthesia · Sep 2007
Dexmedetomidine for pediatric MRI sedation: a review of a series of cases.
The aim of this review was to determine whether dexmedetomidine alone provided satisfactory conditions for children undergoing magnetice resonance imaging (MRI). ⋯ The use of dexmedetomidine for MRI sedation by itself was more unpredictable than anticipated from the published case reports of its use.
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Paediatric anaesthesia · Sep 2007
A review of pediatric regional anesthesia practice during a 17-year period in a single institution.
There is anecdotal evidence of changes in pediatric regional anesthesia (RA) practice. We performed a retrospective review of prospective data on pediatric RA over 17 years in our institution. ⋯ In our hospital, there has been a dramatic increase in RA, mainly from 1989 to 1995. The most remarkable events in the last decade were: (i) the change in practice from neuraxial to peripheral blocks and (ii) the emergence of continuous postoperative analgesia via perineural catheters.