Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2011
Review Meta AnalysisKetamine for perioperative pain management in children: a meta-analysis of published studies.
Balanced analgesia, using both opioid and nonopioids agents, has become the standard care for postoperative pain management. Ketamine, a compound with analgesic and antihyperalgesic properties, has been shown to decrease postoperative pain and opioid requirements in adults. The goal of the present meta-analysis was to investigate postoperative analgesic properties of ketamine in pediatric patients. ⋯ This meta-analysis found that administration of ketamine was associated with decreased PACU postoperative pain intensity and nonopioid analgesic requirement. However, ketamine failed to exhibit a postoperative opioid-sparing effect.
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The prevalence of childhood obesity is increasing. The focus of this review is the special anesthetic considerations regarding the perioperative management of obese children. With obesity the risk of comorbidity such as asthma, obstructive sleep apnea, hypertension, and diabetes increases. ⋯ This has important implications on how to estimate the optimal drug dose. This article offers a review of the literature on definition, prevalence and the pathophysiology of childhood obesity and provides suggestions on preanesthetic evaluation, airway management and dosage of the anesthetic drugs in these patients. The authors highlight the need of supplemental studies on various areas of the subject.
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Paediatric anaesthesia · Jun 2011
Evaluation of laryngoscopic views and related influencing factors in a pediatric population.
Management of the difficult pediatric airway is a serious problem that anesthesiologists face in their practice. However, guidelines for adults may not be applied readily to pediatric populations. ⋯ The difficult cases were mostly aged <1 year. The association between difficult laryngoscopy and the distances between the lower lip border and menthom, ear tragus and corner of the mouth, and ear lobe and corner of the mouth can be summarized in an equation that may have potential use in the prediction of difficult laryngoscopy.
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Paediatric anaesthesia · Jun 2011
Prospective evaluation of the self-pressurized air-Q intubating laryngeal airway in children.
To assess the clinical efficacy of the self-pressurized air-Q ILA™ (ILA-SP). ⋯ Acceptable clinical performance was demonstrated with the ILA-SP for a variety of procedures in infants and children with spontaneous and positive pressure ventilation. Future studies comparing this device to other supraglottic airways may provide useful information regarding the safety of the ILA-SP in pediatric clinical practice.