Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2010
Randomized Controlled Trial Comparative StudyTwo-agent analgesia versus acetaminophen in children having bilateral myringotomies and tubes surgery.
The objective of this study was to determine whether the incidence of emergence agitation (EA) can be reduced by adding an additional, faster onset, non-IV analgesic, intranasal fentanyl or intramuscular (im) ketorolac to rectal acetaminophen. ⋯ We conclude that two-agent analgesia is not superior to acetaminophen alone for decreasing the incidence of EA after inhalation anesthesia with sevoflurane for BM&T surgery. Our overall incidence of EA was low compared to previous studies, which could potentially have decreased our ability to detect differences between groups.
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Paediatric anaesthesia · Nov 2010
Multicenter StudyA novel isotonic-balanced electrolyte solution with 1% glucose for intraoperative fluid therapy in children: results of a prospective multicentre observational post-authorization safety study (PASS).
The recommendations for intraoperative fluid therapy in children have been adapted from hypotonic to isotonic electrolyte solutions with lower glucose concentrations (1-2.5% instead of 5%) to avoid hyponatremia and hyperglycemia. ⋯ The studied isotonic-balanced electrolyte solution with 1% glucose helps to avoid perioperative acid-base imbalance, hyponatremia, hyperglycemia, and ketoacidosis in infants and toddlers and may therefore enhance patient safety.
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Spinal anesthesia is underutilized for surgery in children in Nigeria. Until recently, only caudal and general anesthesia are employed in the pediatric age group, and the thought of spinal anesthesia was an anathema. This study evaluated cardiovascular changes, duration of spinal block, the length of surgery, length of spinal needle to establish lumbar puncture, and the incidence of complications associated with this procedure. ⋯ This study demonstrates that spinal anesthesia in children causes minimal hemodynamic disruption and therefore is a safe technique for lower extremity surgeries. This technique that hitherto has not been popular with children in our environment has been found to be safe and equally effective.
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Paediatric anaesthesia · Nov 2010
Upper airway size and configuration during propofol-based sedation for magnetic resonance imaging: an analysis of 138 infants and children.
Propofol is widely used for pediatric sedation. However, increasing depth of propofol sedation is associated with airway narrowing and obstruction. The aim of this study was to objectively assess airway patency during a low-dose propofol-based sedation regimen by measuring upper airway size and configuration with magnetic resonance imaging (MRI) in spontaneously breathing infants and children. ⋯ Airway patency was maintained in all infants and children sedated with this low-dose propofol-based sedation regimen.
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Paediatric anaesthesia · Nov 2010
Experience with a propofol-ketamine mixture for sedation during pediatric orthopedic surgery.
Various combinations of propofol and ketofol have been described for the provision of procedural sedation in both adults and children. Utilization of 'ketofol' for deep sedation during prolonged pediatric orthopedic procedures has not previously been described. ⋯ Ketofol successfully produced deep sedation for prolonged pediatric orthopedic procedures in conjunction with regional analgesia. Further research to confirm its safety and applicability to a wider range of settings is required.