Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2013
Randomized Controlled Trial Comparative StudyA novel intubation technique in bilateral cleft palate pediatric patients: hard gum shield-aided intubation.
Cleft palate anesthesia is challenging due to difficult airway. Left paraglossal intubation moves resting point of laryngoscope laterally but associated with narrower laryngoscopic view and possible trauma, and we invented the use of hard gum shield as a bridge over defective palate to facilitate intubation with possible wider window and defective tissue protection. ⋯ Hard gum shield-aided intubation facilitated intubation more than left paraglossal in bilateral cleft palate children with shorter intubation time, better glottic view, easier intubation, less need for laryngeal manipulation than left paraglossal intubation with no difference in complications.
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Paediatric anaesthesia · Apr 2013
The characteristics of the staircase phenomenon during the period of twitch stabilization in infants in TOF mode.
Acceleromyography used to monitor the neuromuscular transmission function is available in infants and children. However, information on the so-called staircase phenomenon during the baseline stabilization period in this population is limited. Our objective was to assess the characteristics of such phenomenon in infants in acceleromyography. ⋯ The staircase effect presents in a shorter time course and at lower degrees in smaller infants. However, in older infants, staircase effect still presents in a long period and may influence the onset time and duration of twitch depression after muscle relaxants administration.
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Paediatric anaesthesia · Apr 2013
Randomized Controlled Trial Comparative StudyEmergence delirium in children: a comparison of sevoflurane and desflurane anesthesia using the Paediatric Anesthesia Emergence Delirium scale.
This randomized control trial was designed to evaluate the incidence of emergence delirium (ED) in preschool children receiving sevoflurane or desflurane anesthesia combined with an effective caudal block. ⋯ Sevoflurane and desflurane anesthesia were associated with similar incidences of ED in children undergoing sub-umbilical surgery and receiving effective regional anesthesia. High scores on the first three items of the PAED scale were highly correlated with ED. The items restlessness and inconsolability had lower sensitivity for the diagnosis of ED.
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Paediatric anaesthesia · Apr 2013
Randomized Controlled Trial Comparative StudyEmergence delirium in children: a randomized trial to compare total intravenous anesthesia with propofol and remifentanil to inhalational sevoflurane anesthesia.
Emergence delirium (ED) refers to a variety of behavioral disturbances commonly seen in children following emergence from anesthesia. Vapor-based anesthesia with sevoflurane, the most common pediatric anesthetic technique, is associated with the highest incidence of ED. Propofol has been shown to reduce ED, but these studies have been methodologically limited. ⋯ There was a lower incidence of ED after TIVA. Both intravenous and inhalational inductions were similarly well-tolerated. The use of TIVA was associated with reduced postoperative pain as measured using FLACC scores.
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Paediatric anaesthesia · Apr 2013
Randomized Controlled TrialSteal induction in preschool children: is melatonin as good as clonidine? A prospective, randomized study.
To investigate whether melatonin would be an alternative drug to clonidine for performance of steal induction. ⋯ Melatonin was effective for steal induction in 75% of children compared to 88% of children who had clonidine. Melatonin resulted less effective when administered early in the morning.