Paediatric anaesthesia
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Anesthetic management of the child with post-tonsillectomy hemorrhage is challenging and fraught with hazards such as anemia, hypovolemia, and risk of difficult airway. The aim of this retrospective cohort study was to determine the incidence and further define the anesthetic complications in this population. ⋯ We determined our incidence of ventilatory and hemodynamic complications in a relatively large cohort of children with post-tonsillectomy hemorrhage. Transient hypoxemia was the most common complication and was not related to difficult intubation.
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Paediatric anaesthesia · Nov 2010
Randomized Controlled Trial Comparative StudyImproved analgesia with the ilioinguinal block compared to the transversus abdominis plane block after pediatric inguinal surgery: a prospective randomized trial.
Ultrasound-guided transversus abdominis plane (TAP) block has shown promise for analgesia after pediatric inguinal surgery. This prospective, randomized study tested the hypothesis that the TAP block would provide comparable analgesia after pediatric inguinal surgery compared with a conventional ultrasound-guided ilioinguinal block. ⋯ Following pediatric inguinal surgery, ilioinguinal block provides more effective analgesia than the TAP block.
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Paediatric anaesthesia · Nov 2010
Randomized Controlled TrialThe effect of volume of local anesthetic on the anatomic spread of caudal block in children aged 1-7 years.
To examine the anatomic spread of caudal local anesthetic solution in children aged 1-7 years. ⋯ Incrementally increasing the volume of injectate between 0.5 and 1.0 results in a modest increase in the spread of the caudal solution. It is unlikely that volumes of <1 ml will reliably reach a vertebral level that is higher than L2.
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Paediatric anaesthesia · Nov 2010
Cerebral NIRS as a marker of superior vena cava oxygen saturation in neonates with congenital heart disease.
To investigate the correlation between cerebral near-infrared spectroscopy (NIRS) (rSO2c) and superior vena cava venous oxygen saturation (ScvO2) in newborn patients with congenital heart disease (CHD). ⋯ rSO2c in newborn patients with cyanotic and acyanotic CHD provides a continuous noninvasive information with a fair correlation with ScvO2%: some predictable variables (i.e., time from surgery, carbon dioxide, and venous saturation levels), should guide the operators to adjust rSO2c values in terms of ScvO2. Serial measures of ScvO2 seem recommended to tailor rSO2c information on actual venous saturation percentage.
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Paediatric anaesthesia · Nov 2010
Randomized Controlled TrialSlower administration of propofol preserves adequate respiration in children.
Propofol is a versatile anesthetic agent used in pediatric practice to facilitate investigational and interventional procedures. Propofol can cause significant respiratory depression, the management of which may require advanced airway management skills. This investigation aimed to increase the safety of propofol administration by developing a dosing schedule that would preserve spontaneous respiration in at least 95% of subjects. ⋯ The respiratory response to propofol is highly variable in children. Slower infusion of propofol will result in a lower risk of respiratory depression.