Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2012
ReviewPerioperative management of the pediatric patient with traumatic brain injury.
TBI and its sequelae remain a major healthcare issue throughout the world. With an improved understanding of the pathophysiology of TBI, refinements of monitoring technology, and ongoing research to determine optimal care, the prognosis of TBI continues to improve. In 2003, the Society of Critical Care Medicine published guidelines for the acute management of severe TBI in infants, children, and adolescents. ⋯ The issues reviewed include those related to initial stabilization, airway management, intra-operative mechanical ventilation, hemodynamic support, administration of blood and blood products, positioning, and choice of anesthetic technique. The literature is reviewed regarding fluid management, glucose control, hyperosmolar therapy, therapeutic hypothermia, and corticosteroids. Whenever possible, management recommendations are provided.
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Paediatric anaesthesia · Jul 2012
Randomized Controlled Trial Comparative StudySurgical outcome in children undergoing hypospadias repair under caudal epidural vs penile block.
To evaluate the effect of penile block vs caudal epidural on the quality of analgesia and surgical outcome following hypospadias repair. ⋯ Penile block provided better analgesia when compared with caudal epidural in children undergoing primary hypospadias repair. Postoperative urethral fistula formation was more likely in children who received caudal epidural.
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Paediatric anaesthesia · Jul 2012
Geographic differences in perioperative opioid administration in children.
To investigate whether geographic differences exist in perioperative opioid administration to children. ⋯ Children in Central and South America received less opioid intraoperatively than African and Indian children, under standardized anesthesia for cleft surgeries. Further research is necessary to elucidate the mechanisms underlying these group differences.