Paediatric anaesthesia
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Paediatric anaesthesia · May 2013
Randomized Controlled Trial Comparative StudyDoes take-home analgesia improve postoperative pain after elective day case surgery? A comparison of hospital vs parent-supplied analgesia.
More children are undergoing same-day surgery. While advances have been made in pediatric pain management, there have been few studies addressing pain management in the home (Br J Anaesth, 82, 1999 and 319). We wished to investigate whether issuing parents with take-home analgesia would improve postoperative pain scores and/or parental satisfaction following hospital discharge. ⋯ Our study did not show any differences in the incidence of pain/parental satisfaction between the two groups. Analgesia advice given to parents was poorly retained, suggesting that other methods for disseminating information should be considered.
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Paediatric anaesthesia · May 2013
Randomized Controlled Trial Comparative StudyA randomized comparison of caudal block by sacral hiatus injection under ultrasound guidance with traditional sacral canal injection in children.
There is a risk of inadvertent dural or vascular puncture for the traditional single-shot caudal block performed by inserting the needle into the sacral canal through the sacral hiatus. This prospective, randomized study was to evaluate the clinical feasibility of the hiatus injection under ultrasound guidance for caudal block in children. ⋯ Sacral hiatus injection offers a reliable caudal block for pediatric inguinal hernia repair with the advantages of easier performance and fewer complications compared with traditional sacral canal injection.
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Paediatric anaesthesia · May 2013
Randomized Controlled Trial Comparative StudyPain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolam.
The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the early postoperative period in adolescents who underwent scoliosis surgery. ⋯ Dexmedetomidine was associated with the decreased postoperative fentanyl consumption, NVAS scores, and a decreased incidence of delirium. These findings may be beneficial for managing sedation protocols in adolescents who have undergone scoliosis surgery.
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Paediatric anaesthesia · May 2013
Comparative StudyNebulized lidocaine alone or combined with fentanyl as a premedication to general anesthesia in spontaneously breathing pediatric patients undergoing rigid bronchoscopy.
Pediatric bronchoscopy is an intensely stimulating procedure that requires a deep level of anesthesia to prevent hemodynamic overstimulation and straining. Topical anesthesia of the airway may be a beneficial component of the anesthetic technique to achieve adequate depth without residual sedation. Experimental evidence suggests that in addition to its central effects, locally applied opioids elicit potent analgesic effects. ⋯ It is concluded that preoperative nebulized fentanyl reduces the hemodynamic response to bronchoscopy and decreases the intraoperative coughing in response to surgical manipulation without significant side effects except prolonged time to full wakefulness of patients.