Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2015
Perioperative management of 19 infants undergoing glossopexy (tongue-lip adhesion) procedure: a retrospective study.
Glossopexy (tongue-lip adhesion) is a procedure in which the tongue is anchored to the lower lip and mandible to relieve the upper airway obstruction mainly in infants with Pierre Robin sequence. Infants suffering from severe upper airway obstruction and feeding difficulties due to glossoptosis are the candidates for this procedure and are predicted to demonstrate difficult airway and difficult intubation. ⋯ The airway of these patients should be managed carefully not only before but also after the operation. A nasopharyngeal tube was effective in maintaining the upper airway patency during anesthesia induction and before and after operation.
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Paediatric anaesthesia · Aug 2015
Low incidence of pulmonary aspiration in children allowed intake of clear fluids until called to the operating suite.
International guidelines recommend 2 h of clear fluid fasting prior to general anesthesia. The pediatric anesthesia unit of Uppsala University Hospital has been implementing a more liberal fasting regime for more than a decade; thus, children scheduled for elective procedures are allowed to drink clear fluids until called to the operating suite. ⋯ Shortened fasting times may improve the perioperative experience for parents and children with a low risk of aspiration.
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Paediatric anaesthesia · Aug 2015
Observational StudyThe association of hypotension with the insertion of an abdominal retractor during lower abdominal surgery in pediatric patients: a retrospective observational study.
The Alexis(®) wound retractor is composed of an inner- and outer-ring, with the inner-ring placed inside the abdominal cavity. This placement can constrict the internal organs and large vessels, especially in children, which can lead to hypotension. Our study aimed to investigate the relation between the incidence of hypotension and insertion of the wound retractor during lower abdominal surgery in pediatric patients. ⋯ Patient age and use of a wound retractor with an inner-ring are independent risk factors associated with hypotension during insertion of the abdominal retractor in lower abdominal surgery.
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Paediatric anaesthesia · Aug 2015
Are nocturnal hypoxemia and hypercapnia associated with desaturation immediately after adenotonsillectomy?
Children who undergo adenotonsillectomy for sleep-disordered breathing frequently have postoperative oxygen desaturations. Nocturnal hypoxia has been shown to predict postoperative respiratory complications; however, other gas exchange abnormalities detected on polysomnography (PSG) have not been evaluated. ⋯ Patients <3 years of age are most likely to have postoperative hypoxemia after adenotonsillectomy. Gas exchange abnormalities did not correlate with postoperative desaturations, although age and peak EtCO2 did strongly correlate.