Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2010
Randomized Controlled Trial Multicenter Study Comparative StudyAirway responses to desflurane during maintenance of anesthesia and recovery in children with laryngeal mask airways.
We sought to characterize the airway responses to desflurane during maintenance of and emergence from anesthesia in children whose airways were supported with laryngeal mask airways (LMAs). ⋯ When an LMA is used during desflurane anesthesia in children, fewer airway events occur when it is removed when the child is awake. Although the time to discharge from recovery was not delayed and no child required overnight admission, caution should be exercised when using an LMA in children who are anesthetized with desflurane.
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Paediatric anaesthesia · Jun 2010
Comparative StudyA comparison of bonfils fiberscope-assisted laryngoscopy and standard direct laryngoscopy in simulated difficult pediatric intubation: a manikin study.
Difficult airway management in children is challenging. One alternative device to the gold standard of direct laryngoscopy is the STORZ Bonfils fiberscope (Karl Storz Endoscopy, Tuttlingen, Germany), a rigid fiberoptic stylette-like scope with a curved tip. Although results in adults have been encouraging, reports regarding its use in children have been conflicting. We compared the effectiveness of a standard laryngoscope to the Bonfils fiberscope in a simulated difficult infant airway. ⋯ The Bonfils fiberscope-assisted laryngoscopy was easier to use and provided a better view of the larynx than simple direct laryngoscopy in the simulated difficult pediatric airway, but intubation success rate and time to intubate were not improved. Further studies of the Bonfils fibrescope as a pediatric airway adjunct are needed.
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Paediatric anaesthesia · Jun 2010
Incidence and predictors of hypertension during high-dose dexmedetomidine sedation for pediatric MRI.
This study reviewed the hypertensive response of a large population of children to high-dose dexmedetomidine sedation with the aim of determining the incidence and predictors of hypertension. ⋯ When high-dose dexmedetomidine is used for pediatric sedation for MR imaging, the incidence of hypertension is low. Hypertension is most likely to occur in children <1 year of age during the continuous infusion, after they have received more than one bolus of dexmedetomidine.
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Paediatric anaesthesia · Jun 2010
Influence of external cardiac pacing on cerebral oxygenation measured by near-infrared spectroscopy in children after cardiac surgery.
The brain of children in the early period after repair of congenital heart defects with cardiopulmonary bypass (CPB) may be more vulnerable to hemodynamic changes because of impaired cerebral autoregulation. During postoperative testing of the external temporary safety pacer, we performed desynchronizing ventricular pacing (VVI) while monitoring cerebral oxygenation using near-infrared spectroscopy (NIRS). ⋯ Cardiac desynchronization after CPB seems to reduce CBF and cerebral oxygenation in children.