Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2016
Risk factors for intraoperative allogeneic blood transfusion during craniotomy for brain tumor removal in children.
Several clinical and surgical factors can influence the occurrence of allogeneic blood transfusion (ABT) during oncologic neurosurgery. ⋯ In children, craniotomy for brain tumor removal is at risk of intraoperative ABT. An age <4 years, a duration of surgery >270 min, and a preoperative hemoglobin <12.2 g·dl(-1) are the main factors associated with intraoperative ABT during this surgery.
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Paediatric anaesthesia · Feb 2016
Outpatient outcomes and satisfaction in pediatric population: data from the postoperative phone call.
Quality and patient/parent satisfaction are goals for pediatric perioperative services. As part of the implementation of our operating room electronic medical record (EMR), a postoperative phone call questionnaire was developed to assess patients discharged after outpatient surgery. The goal of this initiative was to determine the rate of common postoperative complications and understand reasons for patient/parent dissatisfaction. ⋯ A postoperative phone survey is cost-effective and appreciated by patients. We found that satisfaction with our perioperative services was not related to the rates of reported complications. Although reducing complications is of utmost importance, improvements in wait times and other operational issues would yield greater improvements in satisfaction.
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Paediatric anaesthesia · Feb 2016
Pediatric emergence delirium: Canadian Pediatric Anesthesiologists' experience.
Pediatric emergence agitation/delirium (ED) is a cluster of behaviors seen in the early postanesthetic period with negative emotional consequences for families and increased utilization of healthcare resources. Many studies have looked at identifying risk factors for ED and at pharmacologic regimens to prevent ED. There are few published reports on treatment options and efficacy for established ED episodes, and essentially no data concerning current practice in the treatment of ED. We sought to elicit the experience and opinions of Canadian Pediatric Anesthesiologists on the incidence of ED in their practice, definitions and diagnostic criteria, preventative strategies, treatments, and their perceived efficacy. ⋯ We present information on current practice patterns with respect to prophylaxis and treatment of ED among a specialized group of pediatric anesthesiologists and highlight the importance of further research in improving the treatment of this common and challenging peri-anesthetic occurrence.
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Paediatric anaesthesia · Feb 2016
Observational StudyPerioperative use of cerebral and renal near-infrared spectroscopy in neonates: a 24-h observational study.
Neonates undergoing surgery and intensive care still carry a significant morbidity and mortality often related to hypoxic/ischemic events; some of which may go undetected by conventional monitoring. Near-infrared spectroscopy (NIRS) is a noninvasive, continuous method of measuring regional tissue oxygen saturation, and may be used to supplement conventional monitoring to improve neonatal perioperative care. However, high costs and lack of evidence regarding improved outcomes have minimized wider perinatal use of NIRS. The aim of this study was to investigate the applicability of NIRS in neonates and premature infants undergoing noncardiac surgeries. ⋯ Near-infrared spectroscopy is an easily applicable technique that appears effective at detecting hypoxic events and postoperative apneas in neonates. The high incidences of regional hypoxia reported by NIRS in this study imply that there is a need for a more specific regional cerebral and renal monitoring. Despite some practical and economical limitations, NIRS may be considered a useful supplement to perinatal perioperative intensive care.
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Paediatric anaesthesia · Feb 2016
Editorial CommentBundled analgesia interventions for day-stay surgery.