Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2014
Randomized Controlled TrialMagnesium as an adjuvant for caudal analgesia in children.
There is a need for an adjuvant agent of caudal block that prolongs its duration and improves the analgesic efficacy to fasten functional recovery. Magnesium is an N-methyl-D-aspartate receptor antagonist that functions as an analgesic. This study was aimed to evaluate whether magnesium as an adjuvant for caudal block in children can improve postoperative analgesia and functional recovery. ⋯ As an adjuvant for caudal analgesia, 50 mg magnesium provided superior quality of analgesia and faster return of normal functional activity than local anesthetic alone in children.
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Paediatric anaesthesia · Dec 2014
Randomized Controlled TrialAnalgesic effects of gabapentin after scoliosis surgery in children: a randomized controlled trial.
Postoperative pain remains an important challenge after scoliosis surgery in children. Opioids are the mainstay of treatment, and adult studies demonstrate gabapentin as a useful adjunct to opioids in the management of postoperative pain. ⋯ A single preoperative dose of gabapentin did not show a significant difference in opioid consumption or pain scores in adolescents undergoing idiopathic scoliosis surgery. This study is the first pediatric randomized controlled trial to assess the effectiveness of a single dose of gabapentin on morphine consumption and analgesia following major surgery.
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Paediatric anaesthesia · Dec 2014
Observational StudyEndotracheal intubation in the pediatric emergency department.
Prospective safety data on emergency department (ED) intubation in children are limited. We aimed to describe the practice and adverse events associated with endotracheal intubation in a large urban pediatric ED. ⋯ Intubation of children in the ED is a low-frequency, high-risk procedure. The incidence of adverse events, particularly desaturation and hypotension, is high. The incidence of difficult laryngoscopy is low. First pass success rate without desaturation or hypotension is low. Strategies to avoid desaturation and hypotension in the peri-intubation setting should be prioritized.
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Paediatric anaesthesia · Dec 2014
Delivery of anesthesia and complications for children with Fraser syndrome: a review of 125 anesthetics.
To perform a retrospective, anesthesia case note review of patients with Fraser syndrome. ⋯ There was a low incidence of complications with this group of patients. However, there is a relatively high incidence of difficult or impossible tracheal intubation (20%) due to glottic stenosis and one patient required an emergency tracheostomy despite no previous clinical evidence of airway narrowing.
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Paediatric anaesthesia · Dec 2014
Variations in inpatient pediatric anesthesia in California from 2000 to 2009: a caseload and geographic analysis.
Regional referral systems are considered important for children hospitalized for surgery, but there is little information on existing systems. ⋯ Many urban California hospitals maintained low annual inpatient anesthetic caseloads for children ≤6 years while conducting potentially more complex procedures. Further efforts are necessary to define the scope of pediatric anesthetic care at urban low- and intermediate-volume hospitals in California.