Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2015
Randomized Controlled Trial Comparative StudyA randomized comparison of the i-gel(™) with the self-pressurized air-Q(™) intubating laryngeal airway in children.
Supraglottic airway devices with noninflatable cuff have advantages in omitting the cuff pressure monitoring and reducing potential pharyngolaryngeal complications. Typical devices without cuff inflation available in children are the i-gel and the self-pressurized air-Q intubating laryngeal airway (air-Q SP). To date, there is no comparative study between these devices in pediatric patients. ⋯ Our results showed that the i-gel had easier insertion and better sealing function, and the air-Q SP provided improved fiberoptic views in children requiring general anesthesia.
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Paediatric anaesthesia · Apr 2015
ReviewAn update on newer pediatric supraglottic airways with recommendations for clinical use.
Supraglottic airways are an established part of routine and emergency pediatric airway management, including use in difficult airways and neonatal resuscitation. With the introduction of newer supraglottic airways in children, efficacy can only be determined by comparing these devices with those that are already well established (laryngeal mask airway Classic and laryngeal mask airway ProSeal). This narrative review aims to present the current literature on these newer supraglottic airways and give recommendations for their use in various clinical scenarios based on the existing evidence.
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Paediatric anaesthesia · Apr 2015
Randomized Controlled Trial Comparative StudyA comparative study of Laryngeal Mask Airway size 1 vs i-gel size 1 in infants undergoing daycare procedures.
The i-gel size 1 is a relatively new, single use, second generation supraglottic airway device. This prospective, randomized, observational study compares the suitability of the i-gel size 1 with the classical Laryngeal Mask Airway (cLaryngeal Mask Airway) size 1 in pediatric patients undergoing elective daycare procedures. ⋯ The OSP of the i-gel size 1 was higher than that of the cLaryngeal Mask Airway. This was statistically significant, although may not be of clinical significance. The i-gel size 1 is less prone to displacement during position changes. However, being a preliminary study carried out on a small number of patients, further trials are warranted to come to any definite conclusion.
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Paediatric anaesthesia · Apr 2015
Practice Guideline GuidelineDevelopment of a guideline for the management of the unanticipated difficult airway in pediatric practice.
Most airway problems in children are identified in advance; however, unanticipated difficulties can arise and may result in serious complications. Training for these sporadic events can be difficult. We identified the need for a structured guideline to improve clinical decision making in the acute situation and also to provide a guide for teaching. ⋯ This paper provides the background, available evidence base, and justification for each step in the resultant guidelines and gives a rationale for their use.
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Paediatric anaesthesia · Apr 2015
Comparative StudyTracheal intubation with the Bonfils fiberscope in the difficult pediatric airway: a comparison with fiberoptic intubation.
Fiberoptic intubation (FOI) is the gold standard for the tracheal intubation in adults with a difficult airway. However, this technique is more difficult in the narrow pediatric airway and the evaluation of alternative devices in children remains desirable. The Bonfils fiberscope (BF) is well described for the difficult airway, but no clinical data assessing its use in the difficult pediatric airway are available. ⋯ Although both the BF and FOI are suitable devices for the intubation of infants and children with difficult airways, the BF may allow faster tracheal intubation with a better image quality and ease of use.