Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2019
STBUR: Sleep Trouble Breathing and Unrefreshed questionnaire: Evaluation of screening tool for post-anesthesia care and disposition.
The Snoring, Trouble Breathing, and Un-Refreshed (STBUR) questionnaire is a five-question screening tool for pediatric sleep-disordered breathing and risk for perioperative respiratory adverse events in children. The utility of this questionnaire as a preoperative risk-stratification tool has not been investigated. In view of limited availability of screening tools for preoperative pediatric sleep-disordered breathing, we evaluated the questionnaire's performance for postanesthesia adverse events that can impact postanesthesia care and disposition. ⋯ The Snoring, Trouble Breathing, and Un-Refreshed questionnaire identified patients at higher risk for prolonged phase 1 recovery, oxygen therapy requirement, and escalation of care. The questionnaire's high-negative predictive value and specificity may make it useful as a screening tool to identify patients at low risk for prolonged stay in PACU.
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Paediatric anaesthesia · Aug 2019
Case ReportsAnesthetic management of a pediatric patient with Loeys-Dietz syndrome: A case report.
Loeys-Dietz syndrome, a rare autosomal dominant disease, is characterized by arterial tortuosity and skeletal manifestations. We report anesthetic management of scoliosis surgery for a pediatric Loeys-Dietz syndrome patient. ⋯ We decided to not conduct rotation correction after discussing risks and benefits of the maneuver with surgeons. Since severe hemodynamic instability is expected in scoliosis surgery for Loeys-Dietz syndrome patients, we should be prepare for hemodynamic collapse and risks and benefits of the operative procedure should be discussed before undertaking the procedure.
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Paediatric anaesthesia · Aug 2019
Case ReportsAnesthetic Management of Acute Nasal Epistaxis occurring during General Anesthesia.
Spontaneous epistaxis under general anesthesia is a rare untoward event. Typically, mild epistaxis occurs from a nasal airway manipulation and usually resolves spontaneously or with external pressure to the affected nares for a short period of time. In case of epistaxis that is difficult to control with pressure or oxymetazoline, thorough evaluation should be considered. We present a case of a 12-year-old experiencing spontaneous nasal bleeding upon emergence difficult to control with noninvasive methods and required intervention by otolaryngology.
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Paediatric anaesthesia · Aug 2019
Randomized Controlled Trial Clinical TrialThe comparison of dexmedetomidine and midazolam premedication on postoperative anxiety in children for hernia repair surgery: a randomized controlled trail.
Perioperative anxiety is common in pediatric patients undergoing surgery. ⋯ Compared with midazolam, a single preoperative intravenous dose of dexmedetomidine appears to provide better postoperative anxiolytic effects for children undergoing same-day surgery.