Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2009
Randomized Controlled Trial Comparative StudyA randomized trial comparing sevoflurane and propofol in children undergoing MRI scans.
We compared three primary outcomes of pausing the magnetic resonance imaging (MRI) scan, emergence quality and respiratory complications. ⋯ Our study compared the three primary outcomes of pausing, agitation, and respiratory complications between the two groups, and we found no difference in respiratory complications. However, the GAP group had more pausing and less agitation than the GAS group.
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Paediatric anaesthesia · Jul 2009
ReviewPediatric transtracheal and cricothyrotomy airway devices for emergency use: which are appropriate for infants and children?
Cricothyrotomy or insertion of a transtracheal device is a life-saving maneuver that may be performed on an emergent or semi-elective basis as a means of bypassing an obstructed upper airway. A surgeon is trained to perform this life-saving procedure whereas most anesthesiologists are not facile with the scalpel. It is for this reason that many percutaneous devices have been developed for use by surgeons and nonsurgeons alike. ⋯ This paper will review many (but not all) of the available devices, associated literature, pitfalls and dangers. It is emphasized that each clinician should become familiar with the advantages and disadvantages of these devices and obtain training with simulators or animal models. A strategy for management of the 'cannot ventilate, cannot oxygenate, cannot intubate' situation should be developed with age and size appropriate equipment.
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Paediatric anaesthesia · Jul 2009
Review Historical ArticleA critique of elective pediatric supraglottic airway devices.
In 1988, when the Laryngeal Mask Airway-Classic (Intavent Orthofix, Maidenhead, UK), was introduced there were only two choices of airway management: tracheal tube or facemask. The supraglottic airway, as we now understand the term, did not exist. Yet, 20 years later, we are faced with an ever increasing choice of supraglottic airway devices (SAD). ⋯ Therefore, most safety data comes from extended use rather than high quality evidence which inevitably biases against newer devices. For reason of these factors, claims of efficacy and particularly safety must be interpreted cautiously. This narrative review aims to present the evidence surrounding the use of currently available pediatric SADs in routine anesthetic practice.