Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2018
Randomized Controlled TrialOn-line preparatory information for children and their families undergoing dental extractions under general anesthesia: A phase III randomized controlled trial.
Family-centered interactive on-line games are increasingly popular in healthcare, but their effectiveness for preoperative preparation needs further research. www.scottga.org is the new on-line version of a proven nonweb-based game for children and parents/caregivers. ⋯ Families believed that a video-game preparation helped their child's perioperative anxiety, but there were no objective measures of behavioral improvement associated with this intervention.
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Paediatric anaesthesia · Feb 2018
Optimum time for intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide in children without any premedication.
Intravenous cannulation is usually done in children after inhalational induction with volatile anesthetic agents. The optimum time for safe intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide has been studied in premedicated children, but there is no information for the optimum time for cannulation with inhalational induction in children without premedication. ⋯ We recommend waiting for 1 minute 45 seconds (105 seconds) after the loss of eyelash reflex before attempting intravenous cannulation in pediatric patients induced with sevoflurane, oxygen, and nitrous oxide without any premedication.
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Paediatric anaesthesia · Feb 2018
Compatibility of common IV drugs with 6% hydroxyethyl starch 130/0.42 and 4% gelatin.
Acetate-containing colloid infusion solutions are recommended to recover normovolemia during pediatric anesthesia. Until now, no studies investigating the compatibility with common anesthetic drugs were available. ⋯ Most of the tested drugs did not show observable incompatibility reactions. However, some common drugs are highly incompatible with colloid infusion solutions: gelatin (cefazolin, diazepam, midazolam, phenytoin, vancomycin), hydroxyethyl starch (diazepam, midazolam, phenytoin, thiopental), and NaCl 0.9% (diazepam, ketamine (S), phenytoin, thiopental). These combinations should be avoided in clinical practice in case there are fewer intravenous lines available than needed.
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Paediatric anaesthesia · Feb 2018
Randomized Controlled TrialUltrasound-guided lower forearm median nerve block in open surgery for trigger thumb in 1- to 3-year-old children: A randomized trial.
Trigger thumb is a common hand disability in children and is primarily treated with open surgery. A conscious median nerve block can usually meet the requirements for trigger thumb-releasing surgery in adults; however, its effectiveness in children requires further clarification. The present study aims to demonstrate whether ultrasound-guided lower forearm median nerve blockade is a viable option for children undergoing open surgery for trigger thumb. ⋯ Ultrasound-guided lower forearm median nerve block can provide more effective analgesia, a higher success rate, and lower general and local anesthetic dosages than the anatomic landmark-based blocking method in children undergoing open surgery for trigger thumb.
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Paediatric anaesthesia · Feb 2018
Observational StudyProspective analysis of serious cardiorespiratory events in children during ophthalmic artery chemotherapy for retinoblastoma under a deep standardized anesthesia.
Serious adverse cardiorespiratory events complicate super selective ophthalmic artery chemotherapy for retinoblastoma in anesthetized children. Their mechanism remains unclear but may be attributed to an autonomic nervous reflex induced by the catheter close to the ophthalmic artery. Inadequate depth of anesthesia during catheter stimulation might be an aggravating factor. Thus, we tested whether deep general anesthesia reduced the incidence of serious cardiorespiratory events. ⋯ Serious cardiorespiratory events occur commonly during super selective ophthalmic artery chemotherapy. Standardized deep anesthesia with analgesia did not appear to be protective. No predictive factors were identified, but these events systematically arose within 2 minutes after ophthalmic artery catheter insertion. Anesthetists and neuroradiologists should be prepared to manage these serious complications and parents should be informed of the risks.