Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2016
Randomized Controlled TrialCould acupuncture be an adequate alternative to dexamethasone in pediatric tonsillectomy?
Usage of nonpharmacological treatment contributes to an overall patient well-being, assisting in physical and emotional healing. Acupuncture has been reported to be useful in reducing early postoperative vomiting (POV) and attenuating postoperative pain. ⋯ Acupuncture at P6 bilaterally and CV13 provided similar antiemetic effect to dexamethasone in children undergoing tonsillectomy.
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Children with chronic pain often undergo surgery and effective perioperative management of their pain can be challenging. Identification of the pediatric chronic pain patient preoperatively and development of a perioperative pain plan may help ensure a safer and more comfortable perioperative course. Successful management usually requires multiple different classes of analgesics, regional anesthesia, and adjunctive nonpharmacological therapies. Neuropathic and oncological pain can be especially difficult to treat and usually requires an individualized approach.
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Paediatric anaesthesia · Aug 2016
Arterial blood pressure in anesthetized neonates and infants: a retrospective analysis of 1091 cases.
Hypotension during general anesthesia in neonates and infants is considered to contribute to poor neurological outcome. ⋯ Hypotension, both postinduction and sustained during surgery, is a common phenomenon in anesthetized children under 1 year, peaking in neonates. Generally accepted lower limits of MAP in anesthetized infants urgently need to be defined, enabling us to develop anesthesia strategies avoiding cerebral hypoperfusion.
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Paediatric anaesthesia · Aug 2016
Predictors of unanticipated admission following ambulatory surgery in the pediatric population: a retrospective case-control study.
Ambulatory surgery plays an important role in pediatric anesthesia. However, it is difficult to predict which patients will experience complications. Age >80, ASA class 3 or 4, duration of surgery >3 h, and BMI 30-35 are independent predictors of unanticipated admission in adults. In this study, we retrospectively evaluate risk factors for unanticipated admission, following ambulatory surgery in children. ⋯ The incidence of unanticipated admission in children following ambulatory surgery is low. Age, ASA class, duration, and time of completion of surgery are predictors common to pediatrics and adults. Interestingly, intraoperative complications, OSA, and type of surgery (ENT, orthopedic, dental) are specific to pediatrics.