Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2015
Randomized Controlled Trial Comparative StudyA comparative study of Laryngeal Mask Airway size 1 vs i-gel size 1 in infants undergoing daycare procedures.
The i-gel size 1 is a relatively new, single use, second generation supraglottic airway device. This prospective, randomized, observational study compares the suitability of the i-gel size 1 with the classical Laryngeal Mask Airway (cLaryngeal Mask Airway) size 1 in pediatric patients undergoing elective daycare procedures. ⋯ The OSP of the i-gel size 1 was higher than that of the cLaryngeal Mask Airway. This was statistically significant, although may not be of clinical significance. The i-gel size 1 is less prone to displacement during position changes. However, being a preliminary study carried out on a small number of patients, further trials are warranted to come to any definite conclusion.
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Paediatric anaesthesia · Apr 2015
Practice Guideline GuidelineDevelopment of a guideline for the management of the unanticipated difficult airway in pediatric practice.
Most airway problems in children are identified in advance; however, unanticipated difficulties can arise and may result in serious complications. Training for these sporadic events can be difficult. We identified the need for a structured guideline to improve clinical decision making in the acute situation and also to provide a guide for teaching. ⋯ This paper provides the background, available evidence base, and justification for each step in the resultant guidelines and gives a rationale for their use.
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Paediatric anaesthesia · Apr 2015
Comparative StudyTracheal intubation with the Bonfils fiberscope in the difficult pediatric airway: a comparison with fiberoptic intubation.
Fiberoptic intubation (FOI) is the gold standard for the tracheal intubation in adults with a difficult airway. However, this technique is more difficult in the narrow pediatric airway and the evaluation of alternative devices in children remains desirable. The Bonfils fiberscope (BF) is well described for the difficult airway, but no clinical data assessing its use in the difficult pediatric airway are available. ⋯ Although both the BF and FOI are suitable devices for the intubation of infants and children with difficult airways, the BF may allow faster tracheal intubation with a better image quality and ease of use.
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Paediatric anaesthesia · Apr 2015
Observational StudyPerioperative respiratory complications following awake and deep extubation in children undergoing adenotonsillectomy.
Perioperative respiratory complications after adenotonsillectomy (T&A) are common and have been described to occur more frequently in children below 3 years of age, those with cranio-facial abnormalities, Down syndrome, obstructive sleep apnea, morbid obesity, and failure to thrive. ⋯ There was no difference in the incidence of perioperative respiratory complications in children undergoing a T&A following an awake vs deep extubation. Only weight ≤14 kg was associated with increased perioperative respiratory complications.
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Paediatric anaesthesia · Apr 2015
Comparative StudyAssessment of three placement techniques for individualized positioning of the tip of the tracheal tube in children under the age of 4 years.
Accurate positioning of the tip of the tracheal tube (tube tip) is challenging in young children. Prevalent clinical methods include placement of intubation depth marks, palpation of the tube cuff in the suprasternal notch, or deliberate mainstem intubation with subsequent withdrawal. To compare the predictability of tube tip positions, variability of the resulting positions in relation to the carina was determined applying the three techniques in each patient. ⋯ Auscultation after deliberate mainstem intubation and cuff palpation resulted in a tube tip position above the carina that was shorter and more predictable than placement of the tube using depth markings.