Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2017
Review Meta Analysis Comparative StudyTotal intravenous anesthesia vs single pharmacological prophylaxis to prevent postoperative vomiting in children: A systematic review and meta-analysis.
In children single-agent antiemetic prophylaxis is as equally effective as TIVA in preventing post-operative vomiting.
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Paediatric anaesthesia · Dec 2017
ReviewThe use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review.
Dipyrone has analgesic, spasmolytic, and antipyretic effects and is used to treat pain. Due to a possible risk of agranulocytosis with the use of dipyrone, it has been banned in a number of countries. The most commonly used data for the use of dipyrone are related to adults. ⋯ In the limited available data, the analgesic efficacy of intravenous dipyrone appears similar to that of intravenous paracetamol. Evidence is lacking to support the claim that dipyrone is equivalent or even superior to Non-Steroid-Anti-Inflammatory-Drugs in pediatric pain. While the absolute risk of agranulocytosis with dipyrone in children, based on available literature, cannot be determined, case reports suggest that this risk is not negligible.
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Paediatric anaesthesia · Dec 2017
A quality improvement initiative to increase the safety of pediatric emergency airway management.
Emergency airway management is commonly associated with life-threatening hypoxia and hypotension which may be preventable. ⋯ Quality improvement initiatives targeting emergency airway management may be successfully implemented in the emergency department and are associated with a reduction in adverse intubation-related events.
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Paediatric anaesthesia · Dec 2017
ReviewWhat is the best size predictor for dose in the obese child?
Lean body mass is commonly proposed for anesthesia maintenance drug dosing calculations. However, total body mass used with allometric scaling has been shown to be better for propofol in obese adults and children. Fat-free mass has also been used instead of lean body mass. ⋯ This fraction (Ffat) will differ for each drug and each parameter affected by body size (eg, clearance and volume of distribution). This fraction is based on the concept of theory-based allometric size. The normal fat mass based on allometric theory and partition of body mass into fat and fat-free components provides a principle-based approach explaining size and body composition effects on pharmacokinetics of all drugs in children and in adults.