Paediatric anaesthesia
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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.
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Paediatric anaesthesia · Jul 2008
Randomized Controlled Trial Comparative StudyPharmacokinetics and analgesic effects of intravenous propacetamol vs rectal paracetamol in children after major craniofacial surgery.
The pharmacokinetics and analgesic effects of intravenous and rectal paracetamol were compared in nonventilated infants after craniofacial surgery in a double-blind placebo controlled study. ⋯ Intravenous propacetamol proved to be more effective than rectal paracetamol in infants after craniofacial surgery. Midazolam was more frequently administered to patients receiving paracetamol suppositories, indicating that these children experienced more distress, possibly caused by pain.