Paediatric anaesthesia
-
Paediatric anaesthesia · Dec 2013
Laryngeal view and temperature measurements while using the perilaryngeal airway (Cobra-PLUS™) in children.
The Cobra-PLUS™ perilaryngeal airway (CP) is a modification of the Cobra perilaryngeal airway. It has a distal curve for easier placement and a thermistor on the pharyngeal cuff. We assessed the orientation of the larynx to the CP and compared temperatures measured using CP to temporal arterial (TA) and infrared tympanic (T) thermometers. ⋯ The CP has a better orientation to the larynx compared with its previous version. It may be used to reliably trend intraoperative temperatures.
-
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.
-
Paediatric anaesthesia · Dec 2013
Ultrasound-guided approach to the paravertebral space for catheter insertion in infants and children.
Paravertebral perineural blocks are used to prevent pain in the thoracoabdominal dermatomes. Traditionally, a landmark-based technique is used in children, while ultrasound-guided (UG) techniques are being employed in adult patients. ⋯ This technical description demonstrates the feasibility of placing PVNB catheters using a transverse in-line ultrasound-guided technique in a wide range of pediatric patients.
-
Paediatric anaesthesia · Dec 2013
Effects of sevoflurane on the expression of tau protein mRNA and Ser396/404 site in the hippocampus of developing rat brain.
General anesthesia induces a transient hyperphosphorylation of tau protein that is associated with neurotoxicity in neonatal rats, but the mechanism remains unknown. The current study sought to investigate the effects of sevoflurane on the levels of tau phosphorylation at phosphor-Ser396/404 and total tau mRNA in the hippocampus of neonatal rats. ⋯ In rat hippocampus, sevoflurane was associated with microtubular disarray as well as increased levels of tau mRNA and excessive phosphorylation of tau protein at Ser396 and Ser404. This implicates that sevoflurane may induce neurotoxicity.
-
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.