Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2016
Randomized Controlled TrialPharmacokinetics and analgesic effectiveness of intravenous parecoxib for tonsillectomy ± adenoidectomy.
Few pharmacokinetic (PK) and pharmacodynamic (PD) data exist for COX-2 selective inhibitors in children. We wished to characterize the PKPD of parecoxib and its active metabolite, valdecoxib, in this population. ⋯ Parecoxib 0.9 mg·kg(-1) in a 2-year-old, 0.75 mg·kg(-1) in a 7-year-old, and 0.65 mg·kg(-1) in a 12-year-old child achieves dose equivalence of 40 mg in a standard 70 kg person. Clearance maturation may occur in infants younger than the current cohort. Parecoxib doses above 1 mg·kg(-1) add no additional analgesia.
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Paediatric anaesthesia · Dec 2016
Observational StudyThe airway device preference may affect the overlapping of the common carotid artery by the internal jugular vein.
Anatomical variation in the internal jugular vein (IJV), as well as its small size, tendency to collapse, and proximity to the common carotid artery (CCA) makes central venous cannulation via the IJV a technically challenging procedure, especially in pediatric patients. ⋯ Laryngeal mask airway with 40° head rotation increases, whereas ETT decreases, the overlap percentage of CCA by IJV. Both head position and airway management methods have an influence on the overlap of the CCA by the IJV in pediatric patients.
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Paediatric anaesthesia · Dec 2016
Evaluation of I-Gel(™) size 2 airway in different degrees of neck flexion in anesthetized children - a prospective, self-controlled trial.
A previous study by our group demonstrated an increase in oropharyngeal leak pressures and a deterioration of ventilation in maximum neck flexion with the I-Gel(™) . To ascertain the optimal degree of neck flexion which increases OPLP without compromising ventilation we conducted a prospective self-controlled trial with the I-Gel(™) in different degrees of neck flexion in anesthetized paralyzed children. ⋯ We conclude that 15° neck flexion can safely be applied without compromising ventilation with the I-Gel(™) in anesthetized paralyzed children. However, Flexion of 30° or more warrants caution or the use of alternative devices like an endotracheal tube due to increase in PIP and worsening of ventilation score.
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Paediatric anaesthesia · Dec 2016
Case ReportsAnesthetic management of premature conjoined twins posted for nonseparation emergency surgery.
Craniopagus conjoined twins are rare, and the chance that an anesthesiologist might face the challenge of providing anesthesia for this condition is very rare. The incidence of conjoined twins ranges from 1 : 50 000 to 1 : 200 000 births. We describe the anesthetic management of a pair of premature craniopagus conjoined twins posted for emergency surgery prior to their separation.
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Paediatric anaesthesia · Dec 2016
The influence of age on positions of the conus medullaris, Tuffier's line, dural sac, and sacrococcygeal membrane in infants, children, adolescents, and young adults.
The purpose of this study was to analyze the distances between the conus medullaris and the Tuffier's line, and between the dural sac and the sacrococcygeal membrane (SCM) in the same pediatric population. ⋯ In children, there is a distance of 1.5-4.75 vertebral body height between the conus medullaris and the Tuffier's line. However, these distances were narrower among younger populations. The distance between the dural sac and the upper limit of the SCM increased with age.