Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2018
Observational StudyA cluster of high psychological and somatic symptoms in children with idiopathic scoliosis predicts persistent pain and analgesic use 1 year after spine fusion.
Persistent postoperative pain is a significant problem for many children, particularly for those undergoing major surgery such as posterior spine fusion. More than two-thirds report persistent pain after spine fusion, yet factors that may contribute to poorer outcomes remain poorly understood. ⋯ Findings from this exploratory study suggest a need to comprehensively assess children with scoliosis for preoperative signs and symptoms that may indicate an underlying vulnerability for persistent pain. This, in turn may help guide a comprehensive perioperative treatment strategy to mitigate the potential for long-term pain trajectories.
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Paediatric anaesthesia · Oct 2018
Clinical and echocardiographic risk factors for extubation failure in infants with congenital diaphragmatic hernia.
Infants after surgical correction of congenital diaphragmatic hernia are at high risk for extubation failure, but little is known about contributing factors. Therefore, our study aimed to analyze clinical and echocardiographic parameters. ⋯ Our results demonstrate that extubation failure in infants with a congenital diaphragmatic hernia is associated with several clinical and echocardiographic risk factors.
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Paediatric anaesthesia · Oct 2018
Observational StudyUltrasound assessment of the prevalence of increased gastric contents and volume in elective pediatric patients: A prospective cohort study.
Though pulmonary aspiration of gastric contents occurs mainly in the setting of emergency surgery, it may also occur in children scheduled for elective surgery without any obvious clinical risk factor. Increased gastric content volume is one the predisposing factors for pulmonary aspiration that could affect such children and may be identified using ultrasound examination of the gastric antrum. ⋯ According to our results, only 1% of elective children had potentially increased risk for pulmonary aspiration. Further studies should be performed in order to define the target population of elective children for which ultrasound assessment of gastric content should be performed prior to general anesthesia.
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Paediatric anaesthesia · Oct 2018
Determining the extent of the dural sac for the performance of caudal epidural blocks in newborns.
Information regarding the position and relationship of vital structures within the caudal canal is important for anesthesiologists who perform a caudal block. This information can be acquired by anatomical dissection, with ultrasound technology, or radiological studies. ⋯ Anesthesiologists should be aware of the short distance between the sacral hiatus and the dural sac when performing caudal blocks, the shortest distance was 4.94 mm. Armed with this knowledge, caudal techniques should be modified to improve the safety and reduce the risk of complications, such as dural puncture.