Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2014
Case ReportsInferior alveolar nerve blocks for postoperative pain control after mandibular distraction with osteotomies in a neonate.
We describe the use of inferior alveolar nerve blocks (IANBs) for postoperative pain control for a neonate undergoing mandibular distraction and osteotomies. In this case, bilateral IANBs were effective in keeping low pain scores as assessed on the neonatal infant pain scale (NIPS) and the amount of opioid and adjuvant analgesics used. ⋯ Additionally, pain control was improved throughout the period of distractor advancement (approximately 7 days). We propose the routine use of this regional technique for improved pain control after this procedure in neonates and suggest that improved pain control may facilitate earlier extubation in this challenging population.
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Paediatric anaesthesia · Jun 2014
Neuropathic pain other than CRPS in children and adolescents: incidence, referral, clinical characteristics, management, and clinical outcomes.
Chronic pain in children and adolescents is common, but proportion of neuropathic pain (NP), a heterogeneous group of diseases with major impact on health-related quality of life, significant economic burden, and limited treatment options, is unclear. Many studies have focused only on complex regional pain syndrome (CRPS). Our aim was to examine the incidence, clinical features, management, and outcome of non-CRPS NP in patients referred to a chronic pediatric pain clinic (CPPC) at a tertiary-care hospital. ⋯ Better understanding of the medical profile of pediatric patients with non-CRPS NP is crucial to timely and correct diagnosis and effective management, but even children with delayed diagnosis still have a good outcome. The management of this condition by an experienced team is recommended.
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Paediatric anaesthesia · Jun 2014
Comparative StudyComparison of regional vs systemic analgesia for post-thoracotomy care in infants.
In infants, post-thoracotomy analgesia traditionally consists of systemic opiates, while regional techniques have gained more favor in recent years. We compare the two techniques for thoracotomy in infants. ⋯ In infants undergoing thoracotomy, loco-regional analgesia is effective and associated with a reduced intensity of postoperative care and earlier full feeding than systemic analgesia; it should therefore be considered a better option.