Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2014
Comparative StudyTime to adequate oxygenation following ventilation using the Enk oxygen flow modulator versus a jet ventilator via needle cricothyrotomy in rabbits.
Limited information is available on the management of the 'cannot intubate, cannot ventilate' (CICV) situation in infants. We compared the time to achieve adequate oxygenation following rescue ventilation using the Enk oxygen flow modulator (OFM) with a jet ventilator in a simulated CICV situation using the rabbit as an infant respiratory model. ⋯ Both devices facilitated successful rescue ventilation through a needle cricothyrotomy.
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Paediatric anaesthesia · Feb 2014
Effect of general anesthesia on pulmonary function and clinical status on children with cystic fibrosis.
Children with cystic fibrosis (CF) receive general anesthesia (GA) for a variety of different procedures. Historical studies assessing risk of GA report a high risk of morbidity. There is a paucity of data evaluating the risk of currently available anesthetic agents. The aim of this study was to assess the effect of GA on clinical status and lung function on children with CF. ⋯ The results suggest that children with mild to moderate CF lung disease do not experience significant deterioration in central or peripheral airway function following GA. The low rate of complications suggests an improved level of safety for children with CF with modern anesthesia compared with historical published data.
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Paediatric anaesthesia · Feb 2014
Randomized Controlled Trial Comparative StudyChildren's cognitive recovery after day-case general anesthesia: a randomized trial of propofol or isoflurane for dental procedures.
Postoperative cognitive dysfunction (POCD) is well established in adults but has been underinvestigated in children. As day-case procedures are increasingly common, it is important to establish whether children suffer significant POCD. Pediatric POCD has been associated with several intravenous and inhalation anesthetics, but isoflurane has not been studied. As evidence indicates superior recovery after propofol, the study compared POCD after propofol or isoflurane anesthesia. ⋯ Propofol and isoflurane exert similar adverse effects on RT, psychomotor coordination, and visual memory. Selective impairment of verbal recall by propofol is consistent with adult evidence of the drug's effect on retrieval. The enduring postoperative impairment of memory has implications for instructions to parents and caregivers for the safety and well-being of children in the 24 h after day-case anesthesia with propofol and isoflurane.