Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2018
Multicenter Study Observational StudyPerioperative outcomes and management in midface advancement surgery: a multicenter observational descriptive study from the Pediatric Craniofacial Collaborative Group.
The evolution of Le Fort III and Monobloc procedures with utilization of distraction devices has resulted in shortened surgical times, greater facial advancements, and decreased transfusion requirements. The aim of this observational study was to utilize data from the multicenter Pediatric Craniofacial Surgery Perioperative Registry to present and compare patient characteristics and outcomes in children undergoing midface advancement with distraction osteogenesis. ⋯ Monobloc procedures were associated with greater transfusion and longer ICU and hospital length of stay. Perioperative complications were more prevalent in the Monobloc group.
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Paediatric anaesthesia · Aug 2018
ReviewCompliance with perioperative prophylaxis guidelines and the use of novel outcome measures.
Postoperative wound infections represent an important source of morbidity and mortality in children. Perioperative antibiotic prophylaxis has been shown to decrease the risk of developing infections and hospital guidelines surrounding antibiotic use exist to standardize patient care. Despite supporting evidence, rates of compliance with guidelines vary. ⋯ Metrics such as days alive out of hospital and length of hospital stay may be useful alternatives for ongoing monitoring of infections and identifying improvements in patient outcomes. Guidelines on antibiotic prophylaxis have facilitated an increase in the correct provision of perioperative antibiotics and a reduction in the incidence of postoperative infection. Measures of patient outcome such as days alive out of hospital and length of hospital stay are easy to collect and calculate but further work is needed to confirm the utility of these measures for monitoring infection rates.
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Paediatric anaesthesia · Aug 2018
Randomized Controlled TrialDorsal penile nerve block for circumcision in pediatric patients: A prospective, observer-blinded, randomized controlled clinical trial for the comparison of ultrasound-guided vs landmark technique.
Circumcision is a frequently performed procedure in day case pediatric surgery. Dorsal penile nerve block has proven its effectiveness for the management of acute postoperative pain after circumcision. We investigated if the ultrasound-guided placement of a dorsal penile nerve block could reduce opioid requirement as compared to a landmark-based technique. ⋯ Compared with the landmark-guided, the ultrasound-guided dorsal penile nerve block did not reduce the need for postoperative analgesia after circumcision in children, but was associated with an increase in the procedural time.
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Paediatric anaesthesia · Aug 2018
Review Historical ArticleThe Ayre's T-piece turns 80: A 21st century review.
Ayre's T-piece, first introduced 80 years ago, continues to be widely used in pediatric anesthesia despite colossal advances in equipment and technology. We present a review of its history, advantages, and disadvantages, and place in modern-day clinical practice.
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Paediatric anaesthesia · Aug 2018
Randomized Controlled TrialEffects of remifentanil maintenance during recovery on emergence delirium in children with sevoflurane anesthesia.
Emergence delirium is a common complication of sevoflurane anesthesia in children. ⋯ Maintaining a low dose of remifentanil (0.05 μg/kg/min) throughout the recovery phase attenuated the incidence of emergence delirium in children undergoing strabismus surgery under sevoflurane anesthesia.