Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2015
Comparative Study Observational StudyA comparison of the postoperative pain experience in children with and without attention-deficit hyperactivity disorder (ADHD).
Children with attention-deficit hyperactivity disorder (ADHD) may experience pain differently compared to other children, yet the evidence is equivocal regarding whether pain is heightened or dampened. This prospective observational study, therefore, was designed to compare the postoperative pain experiences in children with and without ADHD. ⋯ Results suggest that there were no differences in the postoperative pain experiences of children with and without ADHD. However, the observation that children with ADHD took longer to return to baseline activity will be important in educating parents regarding their child's postoperative experience.
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Paediatric anaesthesia · Oct 2015
Randomized Controlled Trial Comparative StudyComparison of different anesthesia techniques during esophagogastroduedenoscopy in children: a randomized trial.
Esophagogastroduedenoscopy (EGD) in children is usually performed under general anesthesia. Anesthetic goals include minimization of airway complications while maximizing operating room (OR) efficiency. Currently, there is no consensus on which anesthetic technique best meets these goals. We performed a prospective randomized study comparing three different anesthetic techniques. ⋯ Respiratory complications were more common in Group NA. The use of native airway with propofol maintenance during EGD does not offer advantages with respect to respiratory complications or institutional efficiency.
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Paediatric anaesthesia · Oct 2015
Comparative Study Observational StudyComparison of the gold standard of hemoglobin measurement with the clinical standard (BGA) and noninvasive hemoglobin measurement (SpHb) in small children: a prospective diagnostic observational study.
Collecting a blood sample is usually necessary to measure hemoglobin levels in children. Especially in small children, noninvasively measuring the hemoglobin level could be extraordinarily helpful, but its precision and accuracy in the clinical environment remain unclear. In this study, noninvasive hemoglobin measurement and blood gas analysis were compared to hemoglobin measurement in a clinical laboratory. ⋯ Noninvasive measurement of hemoglobin agrees more with the reference method than the measurement of hemoglobin using a blood gas analyzer. However, both methods can show clinically relevant differences from the reference method (ClinicalTrials.gov: NCT01693016).
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Paediatric anaesthesia · Oct 2015
ReviewCyanotic congenital heart disease (CCHD): focus on hypoxemia, secondary erythrocytosis, and coagulation alterations.
Children with cyanotic congenital heart disease (CCHD) have complex alterations in their whole blood composition and coagulation profile due to long-standing hypoxemia. Secondary erythrocytosis is an associated physiological response intended to increase circulating red blood cells and oxygen carrying capacity. However, this response is frequently offset by an increase in whole blood viscosity that paradoxically reduces blood flow and tissue perfusion. ⋯ On the other hand, they are at an increased risk for postoperative hemorrhage due to a complex derangement in their hemostatic profile. Anesthesiologists caring for children with CCHD and secondary erythrocytosis need to understand the pathophysiology of these alterations and be aware of available strategies that lessen the risk of bleeding and/or thrombosis. The aim of this review is to provide an updated analysis of the systemic effects of long-standing hypoxemia in children with primary congenital heart disease with a specific focus on secondary erythrocytosis and hemostasis.
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Paediatric anaesthesia · Oct 2015
Case ReportsSuccessful use of ultrasound-guided caudal catheter in a child with a very low termination of dural sac and Opitz-GBBB syndrome: a case report.
We report a 2-year-old patient with Opitz-GBBB syndrome scheduled for a posterior sagittal anorectoplasty (PSARP). The ultrasound scan revealed the inferior end of dural sac just below sacrococcygeal membrane, although the patient had previously two successful caudal epidural blocks. Consequently, the epidural catheter was inserted under a real-time ultrasound guidance without dural puncture. Our patient had excellent pain relief without any side effects.