Paediatric anaesthesia
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Paediatric anaesthesia · May 2014
Postoperative pain during the first week after adenoidectomy and guillotine adenotonsillectomy in children.
Adenoidectomy (AD) and adenotonsillectomy (ATE) are frequently occurring and often painful interventions in children. In literature, it is very prevalent that postoperative pain in children following ATE is hard to control. The purpose of this study was to evaluate the prevalence and severity of postoperative pain in children undergoing AD and ATE in the ambulatory setting. ⋯ Examination of the PPPM and VAS scores illustrated that children undergoing AD were comfortable with acetaminophen as a single analgesic, whereas children undergoing ATE experience significant pain for up to two postoperative days when treated with acetaminophen and diclofenac.
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Arthrogryposis is characterized by multiple, nonprogressive joint contractures which may be caused by maternal disorders such as oligohydramnios as well as fetal akinesia resulting from primary disorders of muscle, connective tissue, or neurologic tissue. Its prevalence is about 1 : 3000. Distal arthrogryposis (DA) is a heterogenous group of genetic disorders with a characteristic flexion of the joints of the hands and feet divided into different types with additional features. Sheldon-Hall Syndrome (SHS), also known as distal arthrogryposis type 2A (DA2A), has some nonorthopedic features of specific importance to anesthetic care.
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Paediatric anaesthesia · May 2014
Case ReportsSuccessful use of C-Mac video laryngoscope in a child with large parapharyngeal mass.
An eleven-year-old child presented with a history of gradually increasing left side neck swelling and snoring for the last 6 years. He was initially scheduled for biopsy and on a second occasion for transcervical excision of left parapharyngeal mass under general anesthesia. Examination showed a left lateral pharyngeal and tonsillar mass compressing the oropharyngeal airway. ⋯ After repeated attempts, intubation was possible with direct laryngoscopic-guided oral FOB. Fifteen days later, for the definitive surgery, the glottis was visualized at the first attempt using a C-Mac video laryngoscope and endotracheal intubation was successful at the first attempt after laryngeal manipulation. We discuss the potential causes of failure of intubation with the other airway devices in this child.
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Paediatric anaesthesia · May 2014
Observational StudyObservational study of perioperative behavior changes in children having teeth extracted under general anesthesia.
Perioperative behavioral disturbance is common in children. Negative behavior changes may be seen during induction of anesthesia, during recovery and following discharge home. There has been little research on this subject in the UK. ⋯ Perioperative behavioral disturbance is common in children undergoing anesthesia. Predicting which children are at increased risk may allow us to adapt the management of these children in order to minimize adverse behavior changes.
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Paediatric anaesthesia · May 2014
Case ReportsManagement of mediastinal syndromes in pediatrics: a new challenge of ultrasound guidance to avoid high-risk general anesthesia.
Adverse events associated with anesthetic management of anterior mediastinal masses in pediatrics are common. To avoid an extremely hazardous general anesthesia, the use of real-time ultrasonography offers an effective alternative in high-risk cases. We report the anesthetic management including a light sedation and ultrasound guidance for regional anesthesia, surgical node biopsy, and placement of a central venous line in two children with an anterior symptomatic mediastinal mass. For pediatric patients with clinical and/or radiologic signs of airway compression, ultrasound guidance provides safety technical assistance to avoid general anesthesia and should be performed for the initial diagnostic and therapeutic procedures.