Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2020
Emergence delirium in children undergoing dental surgery under general anaesthesia.
Emergence delirium is a well-described complication in pediatric anesthesia, occurring more often following short surgical procedures using volatile anesthetics with a rapid recovery profile. Dental extractions and conservation dentistry are commonly performed in children and are not painful postoperatively. The use of nerve blocks and local anesthetic infiltration intraoperatively limits nociception and obviates the need for opioids, allowing for more objective assessment of emergence delirium. ⋯ Emergence delirium occurs commonly after dental surgery, and the majority of the children presenting for dental surgery are anxious at induction. Children with emergence delirium require more interventions in the recovery room but few require pharmacological treatment.
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Paediatric anaesthesia · Sep 2020
Post-operative pain and psychological outcomes following minimally invasive pectus excavatum repair: A report from the Society for Pediatric Anesthesia Improvement Network.
Minimally invasive repair of pectus excavatum (MIRPE) is associated with less tissue trauma; however, it may result in increased postoperative pain. Pain experience is a known risk factor for the development of posttraumatic stress symptoms, though there are little data on its relationship with long-term psychological outcomes following major surgery in pediatric patients. ⋯ Our data suggest that, in patients undergoing MIRPE, the presence of distress at 2 weeks and 3 months may be associated with higher immediate postoperative pain levels.
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Paediatric anaesthesia · Sep 2020
Caregiver anxiety and the association with acute post-operative pain in children undergoing elective ambulatory surgery in a lower-middle-income country setting.
Moderate to severe postoperative pain complicates surgeries performed on children in upper-income countries. The successful management of postoperative pain in children requires a biopsychosocial approach. Situational anxiety and anxiety disorders among caregivers influence a child's perioperative experience. This study aims to determine whether there is an association between caregiver's preoperative anxiety and children's postoperative pain in a lower-middle-income country (LMIC) setting. ⋯ This study showed that preoperative caregiver anxiety is significantly associated with postoperative pain in children undergoing elective, ambulatory surgery in a LMIC setting (correlation of moderate strength). Interventions aimed at reducing caregiver anxiety should become an important component of the biopsychosocial management of postoperative pain in children.
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Paediatric anaesthesia · Sep 2020
A retrospective cohort study of adverse event assessment during anesthesia-related proceduresfor cochlear implant candidacy assessment and cochlear implantationin infants and toddlers.
Cochlear implantation in children with sensorineural hearing loss is preferably performed at youngest age because early auditory input is essential to prevent neural plasticity decline. In contrast, the rate of anesthetic adverse events is increased during infancy. Therefore, to provide recommendations regarding an optimal pediatric implantation age, these possible anesthetic risks in infants need to be taken into account. ⋯ Adverse events occur independent of the age at implantation, the number of anesthetic preoperative procedures, and the type of anesthetic maintenance agent in patients who received a cochlear implant before 24 months of age.