Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2008
Randomized Controlled Trial Comparative StudyPrevention of rocuronium-induced withdrawal movement in children: a comparison of remifentanil with alfentanil.
This study was designed to compare the efficacy of remifentanil and alfentanil without the venous occlusion technique in preventing the withdrawal response associated with rocuronium injection in children. ⋯ Both remifentanil 1 microg.kg(-1) and alfentanil 15 microg.kg(-1) can be used to prevent rocuronium-associated withdrawal movement in children because they are equally effective and attenuate the increase in MAP and HR after intubation.
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Children with learning disabilities can present numerous challenges in the acute hospital setting. This review article examines the causes and presentations of learning disability, and considers some of the management strategies employed when these children present for surgery.
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Paediatric anaesthesia · Mar 2008
Intravenous clonidine infusion in infants after cardiovascular surgery.
The aim of this study was to investigate the hemodynamic profile and heart rhythm in infants who were given intravenous clonidine infusion after prolonged analgesia/sedation following cardiac surgery. ⋯ Although off-label, it is feasible to use clonidine infusions in infants in the PICU setting after cardiac surgery without hemodynamic problems arising.
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Paediatric anaesthesia · Mar 2008
Multicenter StudyStructured training in intraosseous infusion to improve potentially life saving skills in pediatric emergencies - Results of an open prospective national quality development project over 3 years.
Children in emergencies need peripheral intravenous (IV) access in order to receive drugs or fluids. The success of IV access is associated with the age of patients and fails in up to 50% of children younger than 6 years. In such situations, it is essential that physicians and paramedics have a tool and easily learnable skills with a high chance of success. According to international guidelines intraosseous (IO) access would be the next step after failed IV access. Our hypothesis was that the success rate in IO puncturing can be improved by standardizing the training; so we developed an IO workshop. ⋯ Standardized training in IO puncturing seems to improve success more than previous experience and occupation of providers. However, we could not show a significant increase in success rate after this training. Larger supranational studies are needed to show a significant impact of teaching on rarely used emergency skills.