Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2018
Observational StudyEvidence for increased use of the Society of Pediatric Anesthesia Critical Events Checklist in resource-limited environments: A retrospective observational study of app data.
Electronic decision support tools in anesthesiology practice have great value, including the potential for mobile applications to simplify delivery of best-practice guidelines. ⋯ mHealth apps are invaluable resource in everyday clinical practice. Mobile app analytics and in-app survey data reveal variable penetration and applicability of such technology worldwide. mHealth apps may be particularly impactful in limited-resource areas, such as lower-income environments and rural communities.
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Paediatric anaesthesia · Feb 2018
Observational StudyEffect of age on Narcotrend Index monitoring during sevoflurane anesthesia in children below 2 years of age.
In older children, different electroencephalogram-based algorithms for measuring depth of anesthesia displayed a similar performance as in adults, but in infants they have not displayed the same reliability so far. According to the individual developmental state, the Narcotrend distinguishes "differentiated" electroencephalograms, which can be classified using the full Narcotrend Index scale, from "undifferentiated" electroencephalograms, which are classified using a scale with fewer stages. ⋯ The Narcotrend monitor indicated a Narcotrend Index in most infants and young children starting from 4 months with significant correlation to and acceptable prediction probability for minimal alveolar sevoflurane concentration.
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'The association of hypotension with the insertion of an abdominal retractor during lower abdominal surgery in pediatric patients: a retrospective observational study' by Rika Nakayama, Takahiro Mihara, Yoshihisa Miyamoto & Koui Ka.1 The above article from Pediatric Anesthesia, published online on July 7, 2015 in Wiley Online Library (http://wileyonlinelibrary.com) has been retracted by agreement between the authors, the Journal Editor in Chief, Andrew Davidson, and John Wiley & Sons Ltd. The retraction has been agreed following a review of the study data by the authors, which found that cases not satisfying the inclusion criteria were included and that there were data collection errors with respect to the patients' ages and sexes. As a result, the authors judged that the reproducibility of the results could not be guaranteed and have requested retraction. ⋯ Nakayama R, Mihara T, Miyamoto Y, Ka K. The association of hypotension with the insertion of an abdominal retractor during lower abdominal surgery in pediatric patients: a retrospective observational study. Pediatr Anesth. 2015;25:824-828. https://doi.org/10.1111/pan.12656.
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Paediatric anaesthesia · Feb 2018
Optimum time for intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide in children without any premedication.
Intravenous cannulation is usually done in children after inhalational induction with volatile anesthetic agents. The optimum time for safe intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide has been studied in premedicated children, but there is no information for the optimum time for cannulation with inhalational induction in children without premedication. ⋯ We recommend waiting for 1 minute 45 seconds (105 seconds) after the loss of eyelash reflex before attempting intravenous cannulation in pediatric patients induced with sevoflurane, oxygen, and nitrous oxide without any premedication.
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Paediatric anaesthesia · Feb 2018
Randomized Controlled TrialUltrasound-guided lower forearm median nerve block in open surgery for trigger thumb in 1- to 3-year-old children: A randomized trial.
Trigger thumb is a common hand disability in children and is primarily treated with open surgery. A conscious median nerve block can usually meet the requirements for trigger thumb-releasing surgery in adults; however, its effectiveness in children requires further clarification. The present study aims to demonstrate whether ultrasound-guided lower forearm median nerve blockade is a viable option for children undergoing open surgery for trigger thumb. ⋯ Ultrasound-guided lower forearm median nerve block can provide more effective analgesia, a higher success rate, and lower general and local anesthetic dosages than the anatomic landmark-based blocking method in children undergoing open surgery for trigger thumb.