Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2014
Review Meta Analysis Comparative StudyControlled ventilation or spontaneous respiration in anesthesia for tracheobronchial foreign body removal: a meta-analysis.
Either controlled ventilation or spontaneous respiration is commonly used in general anesthesia for inhaled foreign body removal via rigid bronchoscopy. Controversy in the literature exists concerning which form of ventilation is optimally suited for bronchoscopy. We performed a meta-analysis to compare controlled ventilation and spontaneous respiration with respect to complications, operation time, and anesthesia recovery time. ⋯ Current evidence does not show a preference for either controlled ventilation or spontaneous respiration, although laryngospasm has a lower incidence when controlled ventilation is performed. Additional clinical studies are required to substantiate this issue.
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Paediatric anaesthesia · Oct 2014
Randomized Controlled Trial Comparative StudyThe randomized crossover comparison of airway sealing with the laryngeal mask airway Supreme(™) at three different intracuff pressures in children.
An intracuff pressure of 80 cm H2 O in the adult-sized laryngeal mask airway Supreme has been recommended to obtain a higher oropharyngeal leak pressure (OLP). However, the intracuff pressure for the higher OLP in the pediatric laryngeal mask airway Supreme could be different from that in the adult-sized laryngeal mask airway Supreme. Thus, we measured and compared OLP at three intracuff pressures of 40, 60, and 80 cm H2 O in the pediatric laryngeal mask airway Supreme. ⋯ Our results suggest that the use of an intracuff pressure of 60 cm H2 O in pediatric laryngeal mask airway Supreme provides a higher OLP compared with 40 cm H2 O.
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Paediatric anaesthesia · Oct 2014
Three-finger tracheal palpation to guide endotracheal tube depth in children.
Accurate endotracheal tube (ETT) depth is critical, especially in children. The current tools used to guide appropriate ETT depth have significant limitations. ⋯ The use of tracheal palpation to guide ETT placement has excellent clinical performance and better guides appropriate ETT depth than the PALS formula in our study population.
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Paediatric anaesthesia · Oct 2014
Does obesity prolong anesthesia in children undergoing common ENT surgery?
To report the epidemiology of obesity in a pediatric surgical population and determine whether obesity is a risk factor for longer anesthesia duration. ⋯ Children presenting for surgery, particularly the ENT cohort, have a high prevalence of obesity. Obese and nonobese children who had tonsillectomy, adenoidectomy, or both had comparable durations of anesthesia. Therefore, obesity did not lead to longer anesthetic duration.
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Paediatric anaesthesia · Oct 2014
Case ReportsSimple solution for difficult face mask ventilation in children with orofacial clefts.
Significant air leak from the facial cleft predisposes to difficult mask ventilation. The reported techniques of use of sterile gauze, larger face mask and laryngeal mask airway after intravenous induction have limited application in uncooperative children. We describe the use of dental impression material molded to the facial contour to cover the facial defect and aid ventilation with an appropriate size face mask in a child with a bilateral Tessier 3 anomaly.