Paediatric anaesthesia
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Dexmedetomidine has established a firm position in the armamentarium of anesthesia pharmacology. However, it is still a relatively new drug and its application is based on early evidence that is intriguing but far from conclusive. Based on experience with previous cure-alls, anesthesia clinicians and researchers must insist on more information and formulate appropriate science that will allow us to truly understand the role of this dexmedetomidine in our specialty—as wonder drug or also-ran.
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Paediatric anaesthesia · Sep 2015
Are preformed endotracheal tubes appropriately designed for pediatric patients?
The aim of the study was to examine different brands of preformed oral and nasal endotracheal tubes (ETT) and to assess whether the bend placement gave acceptable guidance for ETT depth positioning in children. ⋯ The bend-to-tip distance of preformed ETTs varies between brands, especially for nasal tubes. Some preformed tubes are not well suited for routine use in children. There is a high risk for accidental endobronchial intubation if a cuffed preformed ETT is positioned with its bend at the front teeth or nares in a young child. ETT tube tip position needs to be carefully controlled when a preformed ETT is used in a child.
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Paediatric anaesthesia · Sep 2015
Randomized Controlled TrialDexmedetomidine as adjunct to ilioinguinal/iliohypogastric nerve blocks for pediatric inguinal hernia repair: an exploratory randomized controlled trial.
Adult meta-analysis has identified dexmedetomidine as a potentially useful adjunct to prolong the duration of peripheral nerve blocks. However, no data exist regarding the adjuvant use of dexmedetomidine in the setting of pediatric peripheral nerve blocks. ⋯ The use of dexmedetomidine as an adjunct to an IINB resulted in reduced incidences of CHIPPS pain scores ≥4 and PAED scores of ≥11 during early recovery following pediatric inguinal hernia repair. In addition, the use of adjunct dexmedetomidine was associated with a prolongation of the period to first supplemental analgesia demand. The results of the present exploratory study must be viewed as preliminary and need further validation by future larger sized studies and/or meta-analysis.