Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2014
Randomized Controlled TrialMagnesium as an adjuvant for caudal analgesia in children.
There is a need for an adjuvant agent of caudal block that prolongs its duration and improves the analgesic efficacy to fasten functional recovery. Magnesium is an N-methyl-D-aspartate receptor antagonist that functions as an analgesic. This study was aimed to evaluate whether magnesium as an adjuvant for caudal block in children can improve postoperative analgesia and functional recovery. ⋯ As an adjuvant for caudal analgesia, 50 mg magnesium provided superior quality of analgesia and faster return of normal functional activity than local anesthetic alone in children.
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Paediatric anaesthesia · Dec 2014
Randomized Controlled Trial Comparative StudyPositive-pressure ventilation during transport: a randomized crossover study of self-inflating and flow-inflating resuscitators in a simulation model.
Positive-pressure ventilation during transport of intubated patients is generally delivered via a hand-pressurized device. Of these devices, self-inflating resuscitators (SIR) and flow-inflating resuscitators (FIR) constitute the two major types used. Selection of a particular device for transport, however, remains largely an institutional practice. ⋯ Hand ventilation during patient transport is superior using the FIR compared to the SIR to achieve target ventilatory goals and avoid unacceptable ventilatory cycles.
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Paediatric anaesthesia · Dec 2014
Randomized Controlled TrialTablet-based Interactive Distraction (TBID) vs oral midazolam to minimize perioperative anxiety in pediatric patients: a noninferiority randomized trial.
Perioperative anxiety is a common and undesirable outcome in pediatric surgical patients. The use of interactive tools to minimize perioperative anxiety is vastly understudied. The main objective of the current investigation was to compare the effects of a tablet-based interactive distraction (TBID) tool to oral midazolam on perioperative anxiety. We hypothesized that the TBID tool was not inferior to midazolam to reduce perioperative anxiety. ⋯ A TBID tool reduces perioperative anxiety, emergence delirium, and time-to-discharge and increases parental satisfaction when compared to midazolam in pediatric patients undergoing ambulatory surgery.
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Paediatric anaesthesia · Dec 2014
Case ReportsHemodynamic instability during anesthesia in an adolescent with Loeys-Dietz syndrome: a case report.
We present a case of a 12-year-old male with Loeys-Dietz syndrome (LDS), a rare life-threatening genetic disorder. Multiple manifestations of LDS were present, including easy bruising, aortic root dilatation, multiple areas of vessel tortuosity, and joint laxity. ⋯ He experienced intraoperative hemodynamic instability and became pulseless during an orthopedic procedure, which had to be abandoned. Anesthesia was reattempted 2 days after cessation of the patient's antihypertensive medications and was successful with only minor postoperative hypertension.
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Paediatric anaesthesia · Dec 2014
The effect of convective heating on evaporative heat loss in anesthetized children.
Convective warming is effective in maintaining core temperature under anesthesia. It may increase evaporative water loss (EWL). If significant, further investigation of warming modifications to minimize this impact would be warranted. ⋯ Within the age range 1 month-12 years, EHL is not significantly influenced by convective heating under anesthesia. There is no thermal advantage in exploring technique modifications such as humidifying the warming air. Previous estimates of the contribution of EHL to total heat loss in anesthetized children may require revision.