Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2011
Comparative StudyComparison of epinephrine vs lipid rescue to treat severe local anesthetic toxicity - an experimental study in piglets.
Local anesthetic (LA) intoxication with severe hemodynamic compromise is a potential catastrophic event. Lipid resuscitation has been recommended for the treatment of LA-induced cardiac arrest. However, there are no data about effectiveness of Intralipid for the treatment of severe cardiovascular compromise prior to cardiac arrest. Aim of this study was to compare effectiveness of epinephrine and Intralipid for the treatment of severe hemodynamic compromise owing to bupivacaine intoxication. ⋯ For the treatment of severe hemodynamic compromise owing to bupivacaine intoxication in piglets, first-line rescue with epinephrine was more effective than Intralipid with regard to survival as well as normalization of hemodynamic parameters and ET(CO2) .
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Digby Leigh was a pioneer of Canadian pediatric anesthesia. He was an outstanding man - once met, never forgotten. My only contact with him was at the First Paediatric Anaesthesia Workshop at HSC in Toronto organized by Alan Conn in 1964. ⋯ He moved to Montreal to attend McGill University because there was no medical school in Vancouver. He graduated in 1932 and, like many others, began surgical training at Montreal Children's before Wesley Bourne, Chief of Anaesthesia, persuaded him to change to Anaesthesia. He went to Madison, Wisconsin, and trained with one of the great pioneer teachers, Ralph Waters, for 3 years.
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Paediatric anaesthesia · Nov 2011
ReviewAnesthetic management of congenital tracheoesophageal fistula.
This article reviews (a) risk factors and preoperative considerations of the patient with tracheoesophageal fistula, (b) anesthetic management, including (i) airway management, (ii) induction of anesthesia and monitoring and (iii) postoperative disposition, (c) considerations for concomitant congenital heart disease, (d) considerations for thoracoscopic repair and (e) long-term outcomes and considerations of the patient with repaired esophageal atresia/tracheoesophageal fistula.
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Paediatric anaesthesia · Nov 2011
ReviewNasal foreign bodies in children: considerations for the anesthesiologist.
The combination of a curious young child exploring his/her nasal cavities, with the abundance of small inert and natural objects in our society, culminates in a significant number of nasal foreign bodies (NFBs). Usually NFBs are benign entities, yielding relatively simple resolutions and mild morbidities. ⋯ This article discusses the different types of NFBs, various clinical presentations, diagnosis, pathophysiology, and pertinent considerations for the anesthesia care provider. Increasing one's awareness of the implications of NFBs, can optimize the safe treatment of patients harboring this development.