Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2023
ReviewAssessing Pediatric Perioperative Affect: A Concise Review of Research and Clinically Relevant Scales.
Perioperative anxiety and distress are common in pediatric patients undergoing general anesthesia and increase the risk for immediate and long-term postoperative complications. This concise review outlines key research and clinically-relevant scales that measure pediatric perioperative affect. Strengths and weaknesses of each scale are highlighted. ⋯ Clinically-based anxiety measurement scales tend to be easier to use, however they require further testing before widespread standard utilization. The HRAD ± scale (Happy, Relaxed, Anxious, Distressed, with a yes/no answer to cooperation) may be a promising observational anxiety scale that is efficient and includes an assessment of compliance. Further studies are needed to refine a clinically-relevant anxiety assessment tool and appraise interventions that reduce perioperative distress.
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Paediatric anaesthesia · Mar 2023
Anesthesia and Pain Management of Pediatric Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy.
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy has shown to improve survival in patients with extensive or refractory abdominal tumors of many different histologies. Postoperative pain control can be challenging as the surgical procedure is performed through a midline laparotomy incision from xiphoid to symphysis pubis, and patients are usually nothing by mouth for the first 8-10 postoperative days. ⋯ Utilizing a multimodal, opioid-sparing, total intravenous anesthetic technique in conjunction with a tunneled thoracic epidural catheter, we were able to avoid the need for postoperative mechanical ventilation and minimize both intraoperative and postoperative opioid requirements.
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Paediatric anaesthesia · Mar 2023
Observational StudyRegional oxygen saturation measured by two different oximetry monitors in infants and children undergoing living donor liver transplantation with bilirubin measurements: A prospective observational study.
Tissue oximetry devices use wavelengths in the 680-870 nm range to separate between oxygenated/deoxygenated hemoglobin. Conjugated bilirubin has an absorption peak at 730 nm. ⋯ Oximetry devices emitting light at >2 wavelengths may overcome interference from hyperbilirubinemia providing higher rSO2 readings.