Paediatric anaesthesia
-
Paediatric anaesthesia · Apr 2011
Case ReportsUltrasound-guided bilateral paravertebral continuous nerve blocks for a mildly coagulopathic patient undergoing exploratory laparotomy for bowel resection.
Regional anesthesia techniques commonly utilized in post-operative pain management are often considered contraindicated in coagulopathic patients. We report on successful postoperative pain control utilizing peripheral nerve blockade after exploratory laparotomy with small bowel resection in a mildly coagulopathic patient. ⋯ The patient expressed satisfaction with his pain control. More studies are needed to evaluate the validity of TEG in the prediction of bleeding risk and the safety of this regional technique in a mildly coagulopathic patients.
-
Paediatric anaesthesia · Apr 2011
French current practice for ambulatory anesthesia in children: a survey among the French-speaking Pediatric Anesthesiologists Association (ADARPEF).
This survey aims to describe current practice in ambulatory care among pediatric anesthesiologists in France. ⋯ A better commitment for ambulatory care must be found among anesthesiologists. Further studies are required to improve coherence, safety, and efficiency of children selection for ambulatory anesthesia.
-
Paediatric anaesthesia · Apr 2011
Case ReportsPreventing venous thrombosis in critically ill children: what is the right approach?
The incidence of venous thromboembolic (VTE) events in children has increased in recent years (J Neurosurg, 101, 2004, 32; J Thromb Haemost, 1, 2003, 1443) yet there is currently no consensus as to what VTE prophylaxis, if any, should be applied to the pediatric population. ⋯ There is no consensus in England and Wales as to which VTE prophylactic measures should be applied in patients <18 years of age. The National Institute for Health and Clinical Excellence (NICE) guidelines apply to adults only. Given the rarity of VTE events in children, it is unlikely that randomized controlled trials will provide the answer. We therefore propose that simple empirical measures be formally implemented in critically ill children to reduce the risk of developing this important but under-recognized condition.
-
Paediatric anaesthesia · Apr 2011
Anesthesia can be safely provided for children in a high-field intraoperative magnetic resonance imaging environment.
To describe the challenges associated with providing safe anesthesia and perioperative care for children in a remote intraoperative magnetic resonance (iMR) operating room (OR) and to identify perioperative anesthesia outcomes, including adverse events related to the iMR environment. ⋯ Anesthesia and perioperative care of children in an iMR setting were associated with a very low incidence of complications, despite the duration of the procedures involved. Such success depends upon a cohesive team-based approach.
-
Paediatric anaesthesia · Apr 2011
Feasibility and efficacy of placement of continuous sciatic perineural catheters solely under ultrasound guidance in children: a descriptive study.
Placement of sciatic catheters with ultrasound and stimulating catheters is known. Literature regarding catheter placements with only ultrasound is limited. We aimed to investigate the feasibility of performing continuous sciatic nerve block exclusively with ultrasound guidance and minimal equipment. ⋯ We conclude that in children, continuous sciatic catheters can be accurately and efficaciously placed with minimal equipment with ultrasound alone.