Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2013
Observational StudyPlethysmographic variability index (PVI) accuracy in predicting fluid responsiveness in anesthetized children.
Plethysmographic Variability Index (PVI) has been shown to accurately predict responsiveness to fluid loads in adults. The goal of this study was to evaluate PVI accuracy when predicting fluid responsiveness during noncardiac surgery in children. ⋯ This study found both PVI and prechallenge SVI to be accurate when used to predict fluid load response during anesthetized noncardiac surgery in children. However, a third of recorded PVI values were inconclusive.
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Paediatric anaesthesia · Jun 2013
Comparative StudyLeft femoral vein is a better choice for cannulation in children: a computed tomography study.
Central venous catheters are often required in emergency rooms and intensive care and/or those undergoing major surgical procedures. In this study, we aimed to gain a better understanding of the anatomy of the femoral vessel in relation to central venous cannulation. ⋯ The incidence of overlap of the FA over the FV was significantly lower at the left side in pediatric patients. This finding was similar between the patients aged 2-8 years and those aged 9-16 years and may have significant clinical implications. Guiding clinicians to select the left FV of children for cannulation may result in lower arterial puncture rates while accessing the central vein.
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Paediatric anaesthesia · Jun 2013
Randomized Controlled Trial Comparative StudyComparison of topical tramadol and ketamine in pain treatment after tonsillectomy.
The primary objective of this study is to evaluate the effects of topically applied ketamine or tramadol on early postoperative pain scores in children undergoing tonsillectomy. The secondary aim of the study is to assess nausea, vomiting, difficulty in swallowing, and sore throat characteristics of the patients. ⋯ Topical tramadol and ketamine seem to be safe, effective, and easy analgesic approach for decreasing tonsillectomy pain.
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Paediatric anaesthesia · Jun 2013
Multicenter StudyPrevention of intraoperative hypothermia in neonates and infants: results of a prospective multicenter observational study with a new forced-air warming system with increased warm air flow.
Neonates and infants are at the highest risk of developing perioperative hypothermia. A number of methods to prevent hypothermia during pediatric anesthesia are in use, and despite the fact that conventional forced-air warmers are the most effective devices, they are not always sufficient enough to maintain body temperature. Therefore, recently a new forced-air warming system with an increased warm air flow was introduced to the market. ⋯ The new forced-air warming system as a sole warming device is effective in preventing perioperative hypothermia during pediatric anesthesia in neonates and infants.
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Paediatric anaesthesia · Jun 2013
Randomized Controlled TrialPhenylephrine as a simulated intravascular epidural test dose in pediatrics: a pilot study.
A test dose is used to detect intravascular injection during neuraxial block in pediatrics. Accidental intravascular epidural local anesthetic injection might be unrecognized in anesthetized children leading to potential life-threatening complications. In children, sevoflurane anesthesia blunts the hemodynamic response when intravascular cathecolamines are administered. No studies have explored the hemodynamics and the criteria for a positive test dose result following phenylephrine in sevoflurane anesthetized children. ⋯ Phenylephrine might be a future indicator of positive intravascular test dose. Further investigation is needed to find out the phenylephrine dose that elicits a reliable hemodynamic response and whether phenylephrine needs to be dose age-adjusted in order to appreciate relevant hemodynamic changes in children receiving neuraxial blocks undergoing general anesthesia.