Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2012
Duration of exposure to cranial vault surgery: associations with neurodevelopment among children with single-suture craniosynostosis.
To evaluate associations between neurodevelopment and exposure to surgery and anesthetic agents in children with single-suture craniosynostosis (SSC). ⋯ Average neurodevelopmental scores were lower among children experiencing longer surgeries and higher exposures to inhaled anesthesia. These associations may be due to anesthesia exposure, nonspecific effects of surgery, or unmeasured variables that correlate with surgery duration. Further study of potential causal mechanisms is warranted.
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Paediatric anaesthesia · Nov 2012
Changes in tissue oxygenation following caudal epidural blockade in infants and children.
Adequate tissue oxygenation is required for effective white blood cell function and bactericidal activity. Decreased tissue oxygenation has been shown to be a risk factor for perioperative wound infections. Regional anesthetic techniques result in a functional sympathetic block and may increase tissue oxygenation. The purpose of the current study is to prospectively evaluate changes in tissue oxygenation using a non-invasive near-infrared spectroscopy (NIRS) device following caudal epidural block in infants and children. ⋯ There was a statistically significant increase in tissue oxygenation as measured by NIRS following caudal anesthesia in infants and children. Although the magnitude of the change was less, this study confirms the results of previous studies in adults showing an increase in tissue oxygenation following regional blockade.
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Paediatric anaesthesia · Nov 2012
A prospective audit of safety issues associated with general anesthesia for pediatric cardiac magnetic resonance imaging.
Cardiac MRI (CMR) is increasingly used for surgical planning and serial monitoring of children with congenital heart disease (CHD). For small children, general anesthesia (GA) is required. We describe our experience of the safety of GA for pediatric CMR, using data collected prospectively over 3 years. ⋯ Although the majority of cases were safe and without incident, the complication rate in children with CHD receiving a GA for CMR is higher than in the general pediatric population. This reinforces the need for a senior, multidisciplinary team to be involved in the care of these children during imaging.
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Paediatric anaesthesia · Nov 2012
Anesthesia with sevoflurane and remifentanil under spontaneous respiration assisted with high-frequency jet ventilation for tracheobronchial foreign body removal in 586 children.
Foreign body aspiration is a common life-threatening event in young children. Tracheobronchial foreign body removal is usually performed by rigid tracheobronchoscopy under general anesthesia. Anesthetic and ventilation techniques vary greatly among anesthesiologists and institutions. In the present retrospective study, we report our anesthetic experience over 5 years. We describe complications and outcomes and analyze the clinical characteristics of anesthesia and ventilation. ⋯ Inhaled sevoflurane anesthesia combined with remifentanil infusion, with spontaneous respiration assisted by HFJV and topical airway anesthesia, is safe and effective for tracheobronchial foreign body removal.