Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2021
Review Meta AnalysisEffects of Erector Spinae Plane Block on Postoperative Pain in Children Undergoing Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled trials.
The erector spinae plane block is a novel regional anesthetic technique that is gaining popularity in pediatrics. However, the efficacy of erector spinae plane block in children is unclear. The aim of the systematic review and meta-analysis was to investigate effects of erector spinae plane block on postoperative pain relief in children. ⋯ This review provides low-quality evidence that erector spinae plane block exhibits superior analgesia compared to no block in children. Due to the limited data, evidence regarding the comparison with other regional blocks remains unclear. Future large-sized and well-designed randomized controlled trials are needed.
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Paediatric anaesthesia · Oct 2021
HLA Antibodies and Their Association with Blood Product Exposures in Pediatric Patients Undergoing Cardiac Transplantation.
Previous blood product exposures may result in the development of antibodies to human leukocyte antigens (HLA). Pediatric heart transplant recipients who have these antibodies experience increased morbidity and mortality after transplantation. In this study, our aims were to confirm the association of previous allogeneic blood product exposures with the formation of anti-HLA antibodies, determine which blood components pose the greatest risk of developing antibodies, and assess differences in outcomes after transplantation between patients who had anti-HLA antibodies and those who did not. ⋯ Exposure to previous allogeneic blood products affects the development of anti-HLA antibodies in children presenting for heart transplantation. Previous RBC exposures resulted in HLA antibody positivity more than other blood component exposures. Importantly, the presence of HLA antibodies was associated with the development of DSAs post-transplantation. Developing transfusion strategies to reduce allogeneic blood product exposures in children who may need future cardiac transplantation should be a high priority.
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Paediatric anaesthesia · Oct 2021
Lessons from COVID19 - a reflection on the strengths and weakness of early consensus recommendations for pediatric difficult airway management during a respiratory viral pandemic using a modified Delphi method.
The authors recognized a gap in existing guidelines and convened a modified Delphi process to address novel issues in pediatric difficult airway management raised by the COVID-19 pandemic. ⋯ The consensus process cannot and should not replace evidence-based guidelines; however, it is encouraging to see that the panel's recommendations have held up well as scientific knowledge and clinical experience have grown.
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Paediatric anaesthesia · Oct 2021
Case ReportsPropofol-Induced Uric Acid Crystals: A Case of Cloudy Urine.
Propofol is an intravenous anesthetic agent commonly used intraoperatively as well as in the intensive care unit. Known short-term effects of propofol can include apnea, hypotension, and bradycardia. In children, the rarer adverse sequelae of intravenous anesthetics have received little attention. We present the case of a thirteen-year-old male who incidentally developed uric acid crystals in his urine following a short-duration propofol infusion.
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Paediatric anaesthesia · Oct 2021
Neuraxial anesthesia provides excellent pain control for pediatric burn patients receiving excision and split-thickness skin grafts - a retrospective case series.
Postoperative pain management in pediatric burn patients requiring excision and split-thickness skin grafts remains largely under-studied. ICU care is often necessary due to the level of sedation and amount of opioids required to achieve adequate pain control. ⋯ Spinal anesthesia was most commonly used for split-thickness skin grafting in the pediatric burn population and provides excellent analgesia for patients' immediate postoperative course, including their initial dressing changes, with minimal risk for complications. Pain was well-controlled in all subgroups indicating that this strategy can be used flexibly in a variety of pediatric burn patients.