Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2011
Randomized Controlled TrialEffect of epidural clonidine on minimum local anesthetic concentration (ED50) of levobupivacaine for caudal block in children.
Clonidine has the potential to significantly prolong the duration of caudal epidural anesthesia. We investigated the effect of the addition of clonidine to the MLAC of levobupivacaine in a randomized controlled dose-response trial. ⋯ Clonidine produces a local anesthetic sparing effect with a dose-dependent decrease in levobupivacaine MLAC for caudal anesthesia. In addition, there is a dose-dependent prolongation of postoperative analgesia following lower abdominal surgery in children. A dose of 2 μg·kg(-1) of clonidine provides the optimum balance between improved analgesia and minimal side effects.
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Paediatric anaesthesia · Feb 2011
Comparative StudyThe difficult pediatric airway--a review of new devices for indirect laryngoscopy in children younger than two years of age.
During the last decade, several new look-around-corner or video airway devices have proven useful in clinical adult practice. Only four of them are currently available in sizes that may be used in children younger than 2 years of age: the AIRTRAQ® Disposable Optical Laryngoscope (Prodol Meditec, Vizcaya, Spain), the GlideScope® Video Laryngoscope (Verathon, Bothell, WA, USA), the Storz DCI® Video Laryngoscope (Karl Storz, Tuttlingen, Germany), and the Truview PCD™ Infant (Truphatek, Netanya, Israel). ⋯ The size of the device and the mouth opening it requires determines its usefulness in the smallest infants. Training will be necessary in implementing and deciding when to use the new airway devices, although one of the big challenges of the future will be to maintain the teaching and training of fiber-optic-guided intubations, which remain the gold standard in difficult endotracheal intubations.
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To test the hypothesis that high-dose dexmedetomidine can be successfully used for pediatric magnetic resonance imaging (MRI) sedation without significant hemodynamic compromise. ⋯ High-dose dexmedetomidine can be successfully used for pediatric MRI sedation, but a significant number of children require additional medications for optimal control. Hemodynamic side effects resolved spontaneously. High-dose dexmedetomidine did not result in respiratory depression.
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Paediatric anaesthesia · Feb 2011
Changes of dorsalis pedis artery flow pattern after caudal block in children: observational study using a duplex sonography.
To evaluate the changes of the flow velocity, the volume flow, and the diameter of dorsalis pedis artery using a duplex ultrasonography after caudal block with sevoflurane anesthesia in children. ⋯ Duplex sonographic measurements indicate that a caudal block changes the flow patterns of the dorsalis pedis artery significantly in the anesthetized children.