Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2009
Review Historical ArticlePediatric laryngoscopes and intubation aids old and new.
This review summarizes the evolution of the pediatric laryngoscope using some of the established landmarks in the history of anesthesia. Children were rarely intubated before 1940 though the subsequent 30 years saw a proliferation of pediatric laryngoscopes in part driven by the developments in pediatric anesthesia and surgery, manufacturing techniques and materials and a change in airway management philosophy exemplified by Jackson Rees's argument against the notion that intubation was to be avoided in children. ⋯ Images from many of these devices may be enhanced by digital camera or real-time video technology. The prospect of future laryngoscope development is glimpsed in the arrival of light emitting diode light source technology and questions remain regarding the consequences of equipment disposability and at the fidelity of disposable equipment manufacture.
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Paediatric anaesthesia · Jul 2009
ReviewSedation and analgesia in the pediatric intensive care unit following laryngotracheal reconstruction.
Children undergoing laryngotracheal reconstruction (LTR) may remain electively intubated in the pediatric intensive care unit (PICU) for several days following surgery to facilitate wound healing. These patients require sedation and analgesia with or without neuromuscular blockade in order to prevent excessive head and neck movement with resultant tension on the tracheal anastomosis. Achieving this level of immobility features in caring for these children. ⋯ The aims of this article are to describe a variety of commonly used sedation and analgesic agents and to provide guidance as to their optimal use following LTR.