Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2018
Review Meta AnalysisCaudal and intravenous dexamethasone as an adjuvant to pediatric caudal block: A systematic review and meta-analysis.
Dexamethasone has become a popular additive for regional anesthesia. The aim of this meta-analysis was to assess the effectiveness of this additive on the duration of postoperative analgesia, postoperative vomiting, and possible adverse events in pediatrics. ⋯ Caudal and intravenous dexamethasone could provide longer duration of postoperative analgesia and reduced the incidence of postoperative vomiting with comparable adverse effects than plain caudal block. However, any additive to the caudal space carries with it the potential for neurotoxicity and that caution should always be exercised when weighting the risks and benefits of any additive. The result was influenced by small numbers of participants and significant heterogeneity.
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Paediatric anaesthesia · Mar 2018
Comparative StudyThe prediction probabilities for emergence from sevoflurane anesthesia in children: A comparison of the perfusion index and the bispectral index.
Predicting recovery of consciousness is one of the most essential functions of anesthesia depth monitors in anesthesia practice. Perfusion index and bispectral index are 2 indicators of the anesthesia depth monitoring with different working principles. The progression of the anesthesia emergence stages reflected by those monitors has not been well understood, especially in pediatric patients. The goals of this study were to compare the prediction probabilities of perfusion index and bispectral index in predicting awakening and in differentiating the different levels of arousal during emergence after sevoflurane anesthesia in children undergoing open inguinal hernia repairs. ⋯ Both the perfusion index and bispectral index performed comparably well in predicting awakening and different arousal levels when emerging from sevoflurane anesthesia in children.
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Paediatric anaesthesia · Mar 2018
Case ReportsErector spinae plane block for inguinal hernia repair in preterm infants.
Neuro-axial anesthesia has been the preferred technique for inguinal hernia repair when attempting to avoid general anesthesia in neonates and preterm infants. We present a case where an erector spinae plane block was used successfully for this surgery. Hemodynamic stability, minimal anesthetic requirements, and excellent pain control were documented. This block promises to be a valuable and safe alternative for inguinal hernia repair, accompanying the path of neuroprotective anesthesia.
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Paediatric anaesthesia · Mar 2018
Randomized Controlled TrialSedation for magnetic resonance imaging using propofol with or without ketamine at induction in pediatrics-A prospective randomized double-blinded study.
Deep sedation using propofol has become a standard technique in children. This double-blinded randomized clinical trial aims to compare the clinical effects of propofol-mono-sedation vs a combination of propofol and ketamine at induction and a reduced propofol infusion rate for maintenance in children undergoing diagnostic magnetic resonance imaging. ⋯ Both sedation concepts proved to be reliable with a low incidence of side effects. Ketamine at induction with a reduced propofol infusion rate leads to faster postanesthetic recovery.