Paediatric anaesthesia
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Paediatric anaesthesia · May 2016
Observational StudyAudit of anesthetic trainees' 'hands-on' operating room experience in an Australian tertiary children's hospital.
There are no internationally accepted guidelines about what constitutes adequate clinical exposure during pediatric anesthetic training. In Australia, no data have been published on the level of experience obtained by anesthetic trainees in pediatric anesthesia. There is, however, a new ANZCA (Australian and New Zealand College of Anaesthetists) curriculum that quantifies new training requirements. ⋯ Experience gained at our hospital easily meets the new College requirements. Experience of fiber-optic intubation and regional blocks would appear insufficient to develop sufficient skills or confidence. The study provides other institutions with information to benchmark against their own trainee experience.
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Paediatric anaesthesia · May 2016
Auditory functional magnetic resonance in awake (nonsedated) and propofol-sedated children.
Functional Magnetic Resonance Imaging (fMRI) is often used in preoperative assessment before epilepsy surgery, tumor or cavernous malformation resection, or cochlear implantation. As it requires complete immobility, sedation is needed for uncooperative patients. ⋯ After auditory stimuli, propofol-sedated 5- to 8-year-old children exhibit an fMRI cortical activation pattern which is different from that in similarly aged nonsedated children.
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Paediatric anaesthesia · May 2016
A case series of peripheral nerve blocks in pediatrics and young adults with skeletal dysplasia.
The purpose of this study was to report our experience with peripheral nerve blockade in pediatric and young adult patients with skeletal dysplasia undergoing knee arthroscopy. ⋯ Patients with skeletal dysplasia receiving lower extremity nerve blocks consume minimal opioid and report no major complications. Anesthesiologists should consider this mode of anesthesia in these patients. While no nerve injuries were discovered, further study is necessary to determine whether rates of nerve injury are comparable to that in the general pediatric population. Given the size of the skeletal dysplasia population, this type of study would require close to a decade of metadata from numerous institutions.
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Paediatric anaesthesia · May 2016
Biography Historical ArticlePediatric transport medicine and the dawn of the pediatric anesthesiology and critical care medicine subspecialty: an interview with pioneer Dr. Alvin Hackel.
Dr. Alvin 'Al' Hackel (1932-) Professor Emeritus of Anesthesiology, Perioperative and Pain Medicine, and Pediatrics at the Stanford University School of Medicine, has been an influential pioneer in shaping the scope and practice of pediatric anesthesia. His leadership helped to formally define the subspecialty of pediatric anesthesiology ('who is a pediatric anesthesiologist?') and the importance of specialization and regionalization of expertise in both patient transport and perioperative care. ⋯ Hackel identifies his early involvement in the development of pediatric transport medicine as well as the subspecialty of pediatric anesthesiology as his defining contribution. Based on a series of interviews held with Dr. Hackel between 2009 and 2014, this article reviews the early development of transportation medicine and the remarkable career of a pioneering pediatric anesthesiologist.
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Paediatric anaesthesia · May 2016
Pulmonary aspiration under GA: a 13-year audit in a tertiary pediatric unit.
Pulmonary aspiration is a known risk of general anesthesia. We aim to find out the incidence, risk factors, and outcome of pulmonary aspiration in our pediatric population. ⋯ The incidence of aspiration under general anesthesia in our hospital is comparable to published reports. Our audit highlights the fact that pulmonary aspiration although rare mostly occur in healthy ASA 1 and 2 children with no prior history. Emergency surgeries put the patient at a higher risk of aspiration. They occurred usually during induction, a process which tends to be variable (in technique and duration) for pediatric patients.