Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2020
Randomized Controlled TrialReducing preoperative anxiety with Child Life preparation prior to intravenous induction of anesthesia: a randomized controlled trial.
Induction of anesthesia can be stressful: Up to 60% of children suffer significant anxiety immediately before surgery. Anxiety is associated with higher postoperative analgesia requirements, higher incidence of emergence delirium, and detrimental effects on sleep and behavior. Child Life preparation includes role-play, expectation-setting, and teaching coping strategies. AIM : The aim of this trial was to determine whether preoperative Child Life preparation reduces anxiety prior to intravenous induction of anesthesia. ⋯ A brief, targeted Child Life preparation session had a statistically significant effect on reducing preoperative anxiety prior to intravenous induction of anesthesia in young children, with no known preexisting anxiety. This effect may be clinically important and suggests that Child Life can be a valuable component of pediatric surgical care. Further research is required in specific populations.
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Paediatric anaesthesia · Feb 2020
ReviewEarly Experience with Erector Spinae Plane Blocks in Children.
An erector spinae plane block is a relatively new regional anesthetic technique. Apart from case reports and small series, the literature regarding pediatric use is limited. ⋯ Erector spinae plane blocks are relatively easy to perform in children with no complications reported to date. The efficacy of the block for a broad spectrum of surgeries, involving incisions from T1 to L4, is encouraging.
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Paediatric anaesthesia · Feb 2020
Multicenter StudyAirway management and perioperative adverse events in children with mucopolysaccharidoses and mucolipidoses: a retrospective cohort study.
Children suffering from mucopolysaccharidoses (subtypes I, II, III, IV, VI, and VII) or mucolipidoses often require anesthesia, but are at high risk for perioperative adverse events. However, the impact of the disease subtype and the standard of care for airway management are still unclear. ⋯ The disease subtype and primary airway technique were the most important independent risk factors for perioperative adverse events. Our findings indicate that in MPS/ML children with predicted difficult airway indirect techniques should be favored for the first tracheal intubation attempt.
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Paediatric anaesthesia · Feb 2020
Incidence and Predictors of Postoperative Nausea and Vomiting in Children Undergoing Electrophysiology Ablation Procedures.
Postoperative nausea and vomiting remains a significant concern for patients undergoing general anesthesia for percutaneous radiofrequency catheter ablation and cryoablation for tachyarrhythmias. ⋯ A shorter anesthetic time and a subhypnotic propofol infusion were predictive of a lower rate of postoperative vomiting in patients undergoing general anesthesia for electrophysiologic ablation procedures.