Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2015
Randomized Controlled Trial Comparative StudyComparison of central venous catheterization techniques in pediatric patients: needle vs angiocath.
A needle or an angiocath has been generally used as a route for inserting a guide wire during central venous catheterization. We compared the needle with the angiocath for ultrasound-guided central venous catheterization in pediatric patients concerning accuracy and easiness. ⋯ The angiocath showed no superiority over the needle for ultrasound-guided central venous catheterization in pediatric patients. Regardless of the needle or the angiocath, puncture of the vein was more difficult in newborns than in infants and children.
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Paediatric anaesthesia · Nov 2015
Randomized Controlled TrialCombination of warming blanket and prewarmed intravenous infusion is effective for rewarming in infants with postoperative hypothermia in China.
Postoperative hypothermia in the postanesthesia care unit (PACU) in neonates and infants is a well-known serious complication as it can increase the risk of blood loss, wound infections, and cardiac arrhythmias. ⋯ The combination of conventional blanket rewarming and prewarmed i.v. infusion was shown to be an effective rewarming method for hypothermic infants in China.
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Paediatric anaesthesia · Nov 2015
Comparative StudyA retrospective comparison of ropivacaine and 2-chloroprocaine continuous thoracic epidural analgesia for management of postthoracotomy pain in infants.
Continuous thoracic epidural analgesia is useful in the management of infants following thoracotomy. Concerns about drug accumulation and toxicity limit the amount of amide local anesthetics that can be delivered. Continuous epidural infusions of the ester local anesthetic chloroprocaine result in little drug accumulation allowing for higher infusion rates. We retrospectively compared patients managed with 1.5% 2- chloroprocaine or 0.1% ropivacaine epidural infusions to determine if the increased infusion rate resulted in similar or improved analgesia. ⋯ The use of 2-chloroprocaine for continuous epidural infusion in infants following thoracotomy was not inferior to ropivacaine and there was weak evidence for a reduction in opioid consumption in the first 24 h postoperatively. However, the 2-chloroprocaine group was more likely to receive ketorolac.
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Paediatric anaesthesia · Nov 2015
Middle finger length-based tracheal intubation depth improves the rate of appropriate tube placement in children.
It is challenging for anesthetists to determine the optimal tracheal intubation depth in children. We hypothesize that a measure three times the length of the middle finger can be used for predicting tracheal tube depth in children. ⋯ Our data indicate that the appropriate tube placement rate can be improved by using three times the middle finger length as the tracheal intubation depth in children.
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Paediatric anaesthesia · Nov 2015
Paravertebral nerve block catheters using chloroprocaine in infants with prolonged mechanical ventilation for treatment of long-gap esophageal atresia.
Infants with long-gap esophageal atresia (LGEA) undergo repeated thoracotomies for staged surgical repair known as the Foker process (FP). Associated prolonged mechanical ventilation results in exposure to high doses of opioids and benzodiazepines, and prolonged weaning times and ICU stays. ⋯ Short-term PVNB placement decreases opioid and benzodiazepine exposure, weaning days and ICU stay in infants undergoing prolonged mechanical ventilation for LGEA repair in this small pilot study. Larger studies are warranted to confirm results.