Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2013
Comment LetterReply to the comment on: Witt L, Dennhardt N, Eich C et al. Prevention of intraoperative hypothermia in neonates and infants: results of a prospective multicentre observational study with a new forced-air warming system with increased warm air flow. Pediatr Anesth 2013; 23: 469-474.
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Paediatric anaesthesia · Dec 2013
Multicenter Study Comparative StudyAccuracy of acoustic respiration rate monitoring in pediatric patients.
Rainbow acoustic monitoring (RRa) utilizes acoustic technology to continuously and noninvasively determine respiratory rate from an adhesive sensor located on the neck. ⋯ When compared to nasal capnography, RRa showed good agreement and similar accuracy and precision but was better tolerated in postsurgical pediatric patients.
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Paediatric anaesthesia · Dec 2013
Skin temperature over the carotid artery provides an accurate noninvasive estimation of core temperature in infants and young children during general anesthesia.
The accurate measurement of core temperature is an essential aspect of intraoperative management in children. Invasive measurement sites are accurate but carry some health risks and cannot be used in certain patients. An accurate form of noninvasive thermometry is therefore needed. Our aim was to develop, and subsequently validate, separate models for estimating core temperature using different skin temperatures with an individualized correction factor. ⋯ Skin temperature over the carotid artery, with a simple correction factor of +0.52°C, provides a viable noninvasive estimate of Tnaso in young children during elective surgery with a general anesthetic.
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Paediatric anaesthesia · Dec 2013
A retrospective study of multimodal analgesic treatment after laparoscopic appendectomy in children.
Laparoscopic appendectomy is a common emergency pediatric surgery procedure accompanied by substantial pain (pain scores >4 for >60% of the time) in 33% of these patients. We introduced a bundle of pain management interventions including local anesthetic infiltration at the incision site, intravenous (IV) opioids by patient-controlled analgesia (PCA), and scheduled doses of IV ketorolac and oral acetaminophen/hydrocodone. ⋯ The multimodal regimen of local anesthetic infiltration, opioid by PCA, NSAIDs, and oral acetaminophen/hydrocodone reduced the incidence of substantial pain. Additional studies are required to identify subgroups of patients with minimal opioid requirements who can benefit from modifications of this regimen.