Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2008
A new formula of age-related anatomical landmarks for blockade of the sciatic nerve in the popliteal fossa in children using the posterior approach.
Anatomical landmarks for sciatic nerve blockade are poorly described in children. In adults, the site of puncture of the high approach is located at least 10 cm above the popliteal skin crease. ⋯ These simple landmarks adapted to children age are expected to help the clinicians to perform safely sciatic blocks at the popliteal fossa in young patients.
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Paediatric anaesthesia · Jul 2008
Single injection paravertebral block for renal surgery in children.
Continuous paravertebral block (PVB) has been successfully used for postoperative analgesia in children. However, data regarding the efficacy of a single injection technique for major renal surgery are still lacking. ⋯ Single injection PVB provided clinically relevant postoperative analgesia in children undergoing major renal surgery.
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Paediatric anaesthesia · Jul 2008
Case ReportsEmergency use of a size 1 laryngeal mask airway in a ventilated neonate with an undiagnosed type IV laryngotracheo-oesophageal cleft.
The perioperative management of a neonate with a type IV laryngotracheo-oesophageal cleft and exomphalos major is described. Following an otherwise uncomplicated exomphalos repair, this baby became increasingly and inexplicably difficult to ventilate through an endotracheal tube. The emergency use of a laryngeal mask airway as a rescue maneuver allowed positive pressure ventilation, and subsequent diagnosis of the airway abnormality. The difficulties in management of the two co-existing conditions are discussed.
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Paediatric anaesthesia · Jul 2008
Quality improvement: implementation of a pain management policy in a university pediatric hospital.
Until recently, individual doctors and nurses in our pediatric hospital made decisions about the application of pain relief in patients, resulting in a wide variety of practice. The main task of our pain group was to develop hospital-wide practice standards for acute pain management to improve care. One of the key points of the pain policy was the introduction of pain assessment tools (COMFORT and Visual Analogue Scale). ⋯ Implementation of a pain policy in a pediatric hospital is a difficult process. Pain management in the PACU fell just short of the set target performances. In the surgical ward, embedding the importance of pain assessment remains a challenge and a prerequisite for quality of care in pain management.