Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2015
Observational StudyIncidence of bradycardia at arrival to the operating room after oral or intravenous premedication with clonidine in children.
Clonidine has been advocated as a valid alternative for premedication in children but one of the few limitations is its association with reduced heart rate (HR), which thus raises the question of the safety of clonidine as premedication in children. The aim of this study was to investigate the incidence of bradycardia in children premedicated with oral or intravenous clonidine as compared to children not receiving pharmacologic premedication. ⋯ The incidence of bradycardia following oral or intravenous premedication with clonidine in a pediatric population scheduled for anesthesia is low. Thus, it does not appear rational to refrain from using clonidine as premedication in children only due to fear of bradycardia.
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Paediatric anaesthesia · Sep 2015
Postoperative hypoalbuminemia following surgery related to craniosynostosis.
An episode of postoperative phenytoin toxicity in a patient undergoing surgery related to craniosynostosis highlighted the presence of hypoalbuminemia. We believe that hypoalbuminemia contributed to the altered pharmacokinetics of phenytoin in this case. ⋯ Hemodilution due to large volume blood loss and transfusion with albumin-poor fluids is strongly associated with postoperative hypoalbuminemia in patients undergoing surgery related to craniosynostosis. Practitioners should be aware of this risk and the implications of postoperative hypoalbuminemia in this population.
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Paediatric anaesthesia · Sep 2015
Biography Historical ArticleMalignant hyperthermia in the early days of pediatric anesthesia: an interview with anesthesiology pioneer, Dr. John F. Ryan.
Dr. John F. Ryan (1935 - ), Associate Professor of Anaesthesia at the Harvard Medical School, influenced the careers of hundreds of residents and fellows-in-training while instilling in them his core values of resilience, hard work, and integrity. ⋯ Although he had had many accomplishments, he identified his experiences caring for patients with malignant hyperthermia and characterizing the early discovery of this condition as his defining contribution to medicine. Based on a series of interviews with Dr. Ryan, this article reviews a remarkable career that coincides with the dawn of modern pediatric anesthetic practice.
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Paediatric anaesthesia · Sep 2015
Observational StudyIntranasal dexmedetomidine for sedation in children undergoing transthoracic echocardiography study-a prospective observational study.
Intranasal dexmedetomidine has been used for sedation in children undergoing nonpainful procedures. ⋯ Sedation by intranasal dexmedetomidine at 3 mcg·kg(-1) is associated with acceptable success rate in children undergoing echocardiography with no adverse events in this cohort.
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Paediatric anaesthesia · Sep 2015
High-dose dexmedetomidine for noninvasive pediatric procedural sedation and discharge readiness.
The University of North Carolina's (UNC) Pediatric Sedation Service adopted a noninvasive procedural sedation protocol that uses dexmedetomidine in children based on review of literature that reported fast recovery times and low morbidity. This study aimed to compare dexmedetomidine discharge readiness times observed at UNC with those previously published with a hypothesis that the discharge times at UNC are longer than those previously published. A secondary aim was to evaluate the safety profile of the protocol. ⋯ Dexmedetomidine arousal and discharge times observed at UNC were longer than anticipated when compared to literature. The safety profile of the drug was comparable to prior studies.