Paediatric anaesthesia
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A enjoyable trip down memory lane with Prof. Kester Brown. A brief description of the history of barbiturates and their structure activity relationships, culminating in the seven decade dominance of thiopentone.
The second half of this paper briefly describes the drugs that have challenged thiopentone, those you will likely have used (propofol, etomidate) and those most likely not (propanidid, althesin, gamma-hydroxybutyrate).
An quick and enjoyable read. Click through for the full-text.
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Paediatric anaesthesia · Oct 2013
Randomized Controlled Trial Comparative StudyA randomized comparison of the laryngeal mask airway supreme™ and laryngeal mask airway unique™ in infants and children: does cuff pressure influence leak pressure?
The cuff pressure for optimal airway sealing with first-generation laryngeal mask airway has been shown to be 40 cm H(2)O in children. Currently, there are no data regarding the ideal intracuff pressure for the laryngeal mask airway Supreme (Supreme) in children. ⋯ Intracuff pressures of 40 cm H(2)O may be sufficient for the Supreme in children, and there may be no added benefit of an intracuff pressure of 60 cm H(2)O, as leak pressures were similar. The Supreme may be preferred over the laryngeal mask airway-U for its lower rates of gastric insufflation and provision for gastric access when mechanical ventilation is utilized.
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Paediatric anaesthesia · Oct 2013
Randomized Controlled TrialDigital palpation of endotracheal tube tip as a method of confirming endotracheal tube position in neonates: an open-label, three-armed randomized controlled trial.
To compare the malposition rates of endotracheal tubes (ETTs) when the insertional length (IL) is determined by a weight-based nomogram versus when IL is determined by palpation of the ETT tip. ⋯ Suprasternal palpation shows promise as a simple, safe, and teachable method of confirming ETT position in neonates.
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Paediatric anaesthesia · Oct 2013
Evaluation of the aepEX™ monitor of hypnotic depth in pediatric patients receiving propofol-remifentanil anesthesia.
The aepEX Plus monitor (aepEX) utilizes a mid-latency auditory evoked potential-derived index of depth of hypnosis (DoH). ⋯ The aepEX performs comparable to the BIS in differentiating between consciousness and unconsciousness, while performing inferior to the BIS in terms of distinguishing different levels of sedation and does not correlate well with the C(p) in children receiving propofol-remifentanil anesthesia.