Paediatric anaesthesia
-
Paediatric anaesthesia · Jan 2018
Ultrasound-guided pudendal nerve block in children: A new technique of ultrasound-guided transperineal approach.
Transperineal pudendal nerve block guided by nerve stimulator is used in pediatric anesthesia as an alternative to caudal analgesia in perineal surgery. The risk of rectal puncture or intravascular injection is inherent to this blinded technique. We described a new technique of transperineal pudendal nerve block, with ultrasound guidance, to improve safety of the technique. ⋯ The new technique of ultrasound-guided pudendal nerve block, described in this study, seems to be easy to perform with a good success rate, and probably improves safety of the puncture and of the injection by real-time visualization of anatomical structures and local anesthetic spread.
-
Paediatric anaesthesia · Jan 2018
Comparative StudyPressure-flow characteristics of breathing systems and their components for pediatric and adult patients.
Breathing circuits connect the ventilator to the patients' respiratory system. Breathing tubes, connectors, and sensors contribute to artificial airway resistance to a varying extent. We hypothesized that the flow-dependent resistance is higher in pediatric breathing systems and their components compared to respective types for adults. ⋯ The resistances of pediatric breathing systems and their components result in pressure gradients exceeding those for adults several fold. Considering the resistance of individual components is crucial for composing a breathing system matching the patient's needs. Compensation of the additional resistance should be considered if a large composed resistance is unavoidable.
-
Paediatric anaesthesia · Jan 2018
ReviewAssessment of sedation level prior to neonatal intubation: A systematic review.
Adequate premedication before neonatal endotracheal intubation reduces pain, stress, and adverse physiological responses, diminishes duration and number of attempts at intubation, and prevents traumatic airway injury. Therefore, intubation should not be started until an adequate level of sedation is reached. It is not clear how this should be measured in the clinical situation. ⋯ No validated scoring systems to assess the level of sedation prior to intubation in newborns are available in the literature. Three objective sedation assessment tools seem promising but need further validation before they can be implemented in research and clinical settings.
-
De Barsy syndrome is a rare, autosomal recessive syndrome characterized by cutis laxa, progeroid appearance, ophthalmic opacification, skeletal malformations, growth delays, and intellectual disability. ⋯ This expanded case series suggests that providers caring for patients with de Barsy syndrome should be aware of potential challenges with airway management, vascular access, and temperature monitoring.