Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2019
Lumbosacral and thoracolumbosacral cerebrospinal fluid volume changes in neonates, infants, children, and adolescents: A retrospective magnetic resonance imaging study.
The volume of cerebrospinal fluid can affect the pharmacokinetics and pharmacodynamics of local anesthetics for spinal anesthesia and other intrathecal medications. ⋯ The lumbosacral and thoracolumbosacral cerebrospinal fluid volumes in pediatric patients were much smaller than previously presented values, showing linear correlations with height, and demonstrate curvilinear correlations with age and weight.
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Paediatric anaesthesia · Jan 2019
Evaluation of the quality of acute pain management in a pediatric surgical setting: Validation of a parent proxy modified version of the revised American Pain Society Patient Outcome Questionnaire.
Effective pain management involves a cycle of continual pain assessment, good pain control strategies, and assessment of a standard quality improvement measures. A validated questionnaire that focuses on the quality of postoperative pain management in pediatric surgical patients and parental satisfaction on pain treatment is lacking. We, therefore, modified the revised American Pain Society Patient Outcome Questionnaire to evaluate the quality of postoperative pain management in a pediatric surgical setting. The primary aim of this study was to validate the modified version of revised American Pain Society Patient Outcome Questionnaire. ⋯ The modified version of revised American Pain Society Patient Outcome Questionnaire is a feasible and easy instrument to administer. The questionnaire can be used to obtain feedback from parents about the outcomes and experiences of pain management and is helpful in continuous quality evaluation and improvement in the postoperative care in a pediatric setting.
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Paediatric anaesthesia · Jan 2019
Case ReportsNeonatal anesthesia in low birth weight babies at Hospital Nacional Guido Valadares, Dili, Timor-Leste.
Over a 6-month period, eight neonates weighing less than 3 kg were operated on at Hospital Nacional Guido Valadares, Dili, Timor-Leste. Each was operated on for an abdominal condition. There is no postoperative neonatal ventilation, neonatal inotropes, fluid warmers, or parenteral nutrition available at Hospital Nacional Guido Valadares. ⋯ The resources and time deployed in operating on these small neonates is significant. As difficult as it may be surgical enthusiasm and the uncertainties surrounding prognostication should not displace practical and realistic assessment of the likely outcome of operating on very small babies in low resource facilities where perioperative support is limited. Future development in the Timor-Leste healthcare sector will hopefully provide an environment where improvements in outcome can be achieved.