Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2010
Randomized Controlled TrialEfficacy of two oral premedicants: midazolam or a low-dose combination of midazolam-ketamine for reducing stress during intravenous cannulation in children undergoing CT imaging.
Pain, anxiety and fear of needles make intravenous cannulation extremely difficult in children. We assessed the efficacy and safety of oral midazolam and a low-dose combination of midazolam and ketamine to reduce the stress and anxiety during intravenous cannulation in children undergoing computed tomography (CT) imaging when compared to placebo. ⋯ A low-dose combination of oral midazolam and ketamine or oral midazolam alone effectively reduces the stress during intravenous cannulation in children undergoing CT imaging without any adverse effects. However, the combination provides more children in calm and quiet state when compared to midazolam alone at venipuncture.
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Paediatric anaesthesia · Apr 2010
ReviewAnesthetic considerations for the pediatric oncology patient--part 1: a review of antitumor therapy.
The anesthesiologist who cares for children with cancer or for survivors of childhood cancer should possess a basic understanding of cancer treatment. While this is an ever-changing field, a basic knowledge of chemotherapeutic drugs, radiation therapy, and the toxicities of each is necessary to prepare a safe anesthetic plan. ⋯ This article, which is the first of a three-part review series, will review current principles of cancer therapy and the general mechanisms of toxicity to the child. Although this article is not intended to comprehensively review the fundamentals of chemotherapy and radiation therapy, the consequences of anticancer therapy that impact perioperative care and decision making are presented for the anesthesiologist.
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Paediatric anaesthesia · Apr 2010
Reduced air leakage by adjusting the cuff pressure in pediatric laryngeal mask airways during spontaneous ventilation.
Optimal inflation of the laryngeal mask airway (LMA) cuff should allow ventilation with low leakage volumes and minimal airway morbidity. Manufacturer's recommendations vary, and clinical end-points have been shown to be associated with cuff hyperinflation and increased leak around the LMA. However, measurement of the intra-cuff pressure of the LMA is not routine in most pediatric institutions, and the optimal intra-cuff pressure in the LMA has not been determined in clinical studies. ⋯ Using cuff manometry, an intra-cuff pressure of 40 cmH2O was associated with reduced leak around the LMA while higher (60 cmH2O) and lower (20 cmH2O) cuff pressures resulted in higher leak volumes during spontaneous ventilation. In spontaneously breathing children, reducing the intra-cuff pressure of pediatric-sized LMAs even below the manufacturers' recommendations allows ventilation with minimized leakage around the LMA cuff.
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Paediatric anaesthesia · Apr 2010
Letter Case ReportsAnesthesia in a child with otopalatodigital syndrome.