Paediatric anaesthesia
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Paediatric anaesthesia · May 2009
Randomized Controlled Trial Comparative StudyComparison of propofol-fentanyl with propofol-fentanyl-ketamine combination in pediatric patients undergoing interventional radiology procedures.
With an increase in the frequency of interventional radiology procedures in pediatrics, there has been a corresponding increase in demand for procedural sedation to facilitate them. The purpose of our study was to compare the frequency of adverse effects, sedation level, patient recovery characteristics in pediatric patients receiving intravenous propofol fentanyl combination with or without ketamine for interventional radiology procedures. Our main hypothesis was that the addition of ketamine would decrease propofol/fentanyl associated desaturation. ⋯ In conclusion, addition of low dose ketamine to propofol-fentanyl combination decreased the risk of desaturation and it also decreased the need for supplemental propofol dosage in pediatric patients at interventional radiology procedures.
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Paediatric anaesthesia · May 2009
Randomized Controlled Trial Comparative StudyA randomized study of a new landmark-guided vs traditional para-carotid approach in internal jugular venous cannulation in infants.
Central venous catheterization is more difficult in infants than in adults. Ultrasound-guided internal jugular venous cannulation may improve the accuracy of localization of the internal jugular vein (IJV), but ultrasound equipment is not universally available. The landmark technique remains essential in daily practice. ⋯ Compared with traditional para-carotid approach, the new landmark-guided approach for access of the IJV during teaching central catheterization significantly reduced carotid arterial puncture, provided a higher success rate and minimized procedure time in infants aged 3-12 months.
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Paediatric anaesthesia · May 2009
ReviewThe efficacy and effect of opioid analgesia in undifferentiated abdominal pain in children: a review of four studies.
The question of whether opioid analgesia should be given in patients with undifferentiated acute abdominal pain has been characterized by concerns about its efficacy and that signs used to determine accurate diagnosis may be masked by the drug. The objective of this review is to critically analyze pertinent pediatric randomized controlled studies considering this issue. ⋯ A large, probably multi-centred trial is needed to answer with sufficient power the question of whether opioid analgesia impairs diagnostic accuracy in children with undifferentiated acute abdominal pain.
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Paediatric anaesthesia · May 2009
ReviewSpecialist training in pediatric anesthesia - the Scandinavian approach.
There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. ⋯ The program also includes three theoretical courses each of 4 days duration and a 4-week exchange module at another pediatric center inside or outside Scandinavia. In this article the Scandinavian training program in pediatric anesthesia and intensive care is presented and discussed in more details. International collaboration on how best to arrange and organize a training program in pediatric anesthesia and intensive care is encouraged.
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Paediatric anaesthesia · May 2009
ReviewTranscutaneous carbon dioxide monitoring in infants and children.
To review the technology required for and the applications of transcutaneous carbon dioxide (TC-CO2) monitoring in infants and children. ⋯ Transcutaneous carbon dioxide monitoring may be a useful adjunct in various clinical scenarios in infants and children. It should be viewed as a complimentary technology and may be used in combination with ET-CO2 monitoring.