Paediatric anaesthesia
-
Paediatric anaesthesia · Aug 2022
Observational StudyThe impact of modified fluid gelatin 4% in a balanced electrolyte solution on plasma osmolality in children - a non-interventional observational study.
Intravenous fluids for perioperative infusion therapy should be isotonic to maintain the body fluid homeostasis in children. Modified fluid gelatin 4% in a balanced electrolyte solution has a theoretical osmolarity of 284 mosmol L-1 , and a real osmolality of 264 mosmol kg H2 O-1 . Because both values are lower than those of 0.9% saline or plasma, gelatin would be expected to be hypotonic in-vitro and in-vivo. ⋯ Gelatin in a balanced electrolyte solution has isotonic characteristics in-vitro and in-vivo, despite the low theoretical osmolarity, probably caused by the (unmeasured) negative charges in the gelatin molecules contributing to the plasma osmolality. For a better evaluation of the (real) tonicity of gelatin-containing solutions, we suggest to calculate the osmolality (mosmol kg H2 O-1 ) using Zander's formula.
-
Paediatric anaesthesia · Aug 2022
Paediatric Lower limb Peripheral Nerve blocks: indications, effectiveness and the incidence of adverse events.
While the proportion of pediatric anesthetics with regional anesthesia in pediatric patients has steadily increased, there are only a few series that describe the use of lower limb peripheral nerve blocks in children. Our aim was to describe the indications, anesthetic approach, and complications associated with lower limb blocks in children undergoing orthopedic surgery in a center with a large caseload of complex patients. ⋯ An increased risk of perioperative peripheral nerve injury is associated with pediatric tibial osteotomy for congenital deformity. While popliteal sciatic nerve block was not directly implicated in the nerve injury the presence of a prolonged sensory block can delay early recognition and treatment of peripheral nerve injury.
-
Paediatric anaesthesia · Aug 2022
Patient and Operative Factors Associated with Unanticipated Intensive Care Admission and Outcomes Following Posterior Fossa Decompressions in Children: A Retrospective Study.
Posterior fossa decompression for Chiari I Malformation is a common pediatric neurosurgical procedure. We sought to identify the impact of anesthesia-related intraoperative complications on unanticipated admission to the intensive care unit and outcomes following posterior fossa decompression. ⋯ Our study demonstrates that although anesthesia-related intraoperative complications during posterior fossa decompression are infrequent, they are associated with an increased risk of an unanticipated admission to the intensive care unit.
-
Paediatric anaesthesia · Aug 2022
The Association of Severe Pain Experienced in the PICU and Post-Discharge Health-Related Quality of Life: A Retrospective Cohort Study.
Pain may be a modifiable risk factor for lower health-related quality of life after pediatric critical illness. ⋯ Children who experience severe pain in the pediatric intensive care unit have lower postdischarge health-related quality of life adjusting for baseline health-related quality of life, particularly among children who have undergone surgery. Attention to pain management may be important to improve postdischarge health-related quality of life.