Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2020
Observational StudyAnesthetic Management of Catheter-Based Patent Ductus Arteriosus Closure in Neonates Weighing Less Than Three Kilograms: A Retrospective Observational Study.
The patent ductus arteriosus is a cardiac lesion commonly found in premature neonates. Though surgical closure via thoracotomy is the most definitive treatment option, it is associated with significant morbidity. New catheter-based closure options offer a potentially safer alternative treatment, even in premature neonates. However, no literature reports the anesthetic techniques, challenges, and risks associated with this procedure in this population. ⋯ Despite multiple clinical and logistical challenges, anesthetic risk associated with catheter-based PDA closure in small neonates can be effectively managed through standardized and multidisciplinary care.
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Paediatric anaesthesia · Apr 2020
Reducing postoperative pain in children undergoing strabismus surgery: from bundle implementation to clinical decision support tools.
Postoperative pain is a significant cause of morbidity in pediatric anesthesia, which can result in delayed discharge and unplanned hospital admission. Children undergoing strabismus surgery are known to be a particularly high-risk group for postoperative pain. ⋯ Through the implementation and adoption of an evidence-based bundle of care, we successfully decreased the incidence of moderate to severe postoperative pain for children undergoing strabismus repair. We demonstrated that combining nudge theory with QI methodology can be an effective means of delivering positive results in quality improvement projects.
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Paediatric anaesthesia · Apr 2020
Randomized Controlled TrialA Prospective, Randomized Comparative Study Between Ultrasound-Guided Posterior Quadratus Lumborum Block and Ultrasound-Guided Ilioinguinal/Iliohypogastric Nerve Block for Pediatric Inguinal Herniotomy.
Ilioinguinal/iliohypogastric nerve block is commonly performed to control postherniotomy pain. The posterior quadratus lumborum block has been recently described as an effective analgesic technique for pediatric low abdominal surgery. No data were found regarding the use of posterior quadratus lumborum block in comparison with the traditional ilioinguinal/iliohypogastric nerve block in pediatric inguinal surgery. ⋯ The posterior quadratus lumborum block with 0.25% bupivacaine 0.5 mL/kg provided better pain control than the ilioinguinal/iliohypogastric nerve block with 0.25% bupivacaine 0.2 mL/kg after open herniotomy in children. The ultrasound guidance technique for the posterior quadratus lumborum block is safe and as simple as the ultrasound-guided ilioinguinal/iliohypogastric nerve block for pediatric patients.