Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2018
Randomized Controlled TrialDexmedetomidine for the reduction of emergence delirium in children undergoing tonsillectomy with propofol anesthesia: A double-blind, randomized study.
Postanesthesia emergence delirium is a motor agitation state complicating pediatric anesthesia. We investigated the efficacy of dexmedetomidine in reducing emergence delirium in children undergoing tonsillectomy with and without adenoidectomy using total intravenous anesthesia with propofol. ⋯ Dexmedetomidine 1 mcg kg-1 reduces the incidence and severity of emergence delirium after tonsillectomy with propofol anesthesia without prolonging the extubation time.
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Paediatric anaesthesia · Jul 2018
Time to consider the contact force during photoplethysmography measurement during pediatric anesthesia: A prospective, nonrandomized interventional study.
Respiratory variations in photoplethysmography amplitude enable volume status assessment. However, the contact force between the measurement site and sensor can affect photoplethysmography waveforms. We aimed to evaluate contact force effects on respiratory variations in photoplethysmography waveforms in children under general anesthesia. ⋯ Respiratory variations in photoplethysmography amplitude changed according to variable contact forces; therefore, these measurements may not reflect respiration-induced stroke volume variations. Clinicians should consider contact force bias when interpreting morphological data from photoplethysmography signals.
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Paediatric anaesthesia · Jul 2018
Correlation between minute carbon dioxide elimination and pulmonary blood flow in single-ventricle patients after stage 1 palliation and 2-ventricle patients with intracardiac shunts: A pilot study.
Assessment of pulmonary blood flow and cardiac output is critical in the postoperative management of patients with single-ventricle physiology or 2-ventricle physiology with intracardiac shunting. Currently, such hemodynamic data are only obtainable by invasive procedures, such as cardiac catheterization or the use of a pulmonary artery catheter. Ready availability of such information, especially if attainable noninvasively, could be a valuable addition to postoperative management. ⋯ Volume of CO2 elimination may be a surrogate marker of pulmonary blood flow in single-ventricle patients and patients with biventricular physiology with intracardiac shunting. Also, among patients with normal cardiac anatomy, volume of CO2 elimination may be a marker of cardiac output.
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Paediatric anaesthesia · Jul 2018
Association between sugammadex and anaphylaxis in pediatric patients: A nested case-control study using a national inpatient database.
Sugammadex is used as a reversal drug during anesthesia. Although several case reports have described anaphylaxis following sugammadex infusion, little is known about the relationship between sugammadex and anaphylaxis, particularly in pediatric patients. ⋯ The present study showed no significant association between sugammadex and perioperative anaphylaxis in pediatric patients who underwent general anesthesia.
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Paediatric anaesthesia · Jul 2018
Low-dose dexmedetomidine as an adjuvant to propofol infusion for children in MRI: A double-cohort study.
Propofol is an effective sedative for magnetic resonance imaging. Nevertheless, it may cause hemodynamic and respiratory complications in a dose dependent fashion. We investigated the role of low-dose dexmedetomidine (0.5 μg/kg) as an adjuvant to propofol sedation for children undergoing magnetic resonance imaging. We hypothesized that dexmedetomidine would decrease the propofol dose required, airway complications, and hemodynamic instability. ⋯ A low-dose bolus of dexmedetomidine (0.5 μg/kg) used as an adjuvant can decrease the propofol requirement for children undergoing sedation for magnetic resonance imaging. This may decrease the need for airway support and contribute to improved hemodynamic stability without prolonging recovery time.