Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2012
Randomized Controlled TrialDexmedetomidine vs midazolam for premedication of pediatric patients undergoing anesthesia.
Dexmedetomidine, an α(2)-receptor agonist, provides sedation, analgesia, and anxiolytic effects, and these properties make it a potentially useful anesthetic premedication. In this study, we compared the effects of intranasal dexmedetomidine and midazolam on mask induction and preoperative sedation in pediatric patients. ⋯ Intranasal dexmedetomidine and midazolam are equally effective in decreasing anxiety upon separation from parents; however, midazolam is superior in providing satisfactory conditions during mask induction.
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Paediatric anaesthesia · Sep 2012
Randomized Controlled Trial Comparative StudyA randomized controlled trial comparing the AccuVein AV300 device to standard insertion technique for intravenous cannulation of anesthetized children.
To evaluate the efficacy of the AccuVein AV300 device in improving the first-time success rate of intravenous cannulation of anesthetized pediatric patients. ⋯ There were 146 patients with a median age of 4.6 years (range, 0.18-17.1 years), 46.6% were male, 80.8% were light skin colored, and 15.7% were younger than 2 years. The first-attempt success rates were 75% (95% CI, 63.8-84.2%) using AV300 and 73% (95% CI, 61.9-81.9%) using the standard method (P = 0.85). Patients with dark or medium skin color were 0.38 times less likely to have a successful first attempt than patients with light skin color. The difference between the two treatment groups in number of skin punctures and the time to insertion was not significant. Although the AV300 was easy to use and improved visualization of the veins, we found no evidence that it was superior to the standard method of intravenous cannulation in unselected pediatric patients under anesthesia.
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Paediatric anaesthesia · Sep 2012
Anesthetic care and perioperative complications of children with Morquio syndrome.
Our objective was to make recommendations based on our experience and findings from this study regarding the anesthetic care of children with Morquio syndrome (MS). We emphasize information not readily available in the Anesthesiology literature. ⋯ Morquio syndrome results in abnormalities of not only upper airway but also of large airways. Information from 83 intubations of 108 anesthetics (in 28 patients) shows a preference for Glidescope when intubating children with MS. Displacing the tongue anteriorly prior to intubation by manual retraction using a ring forceps or a piece of gauze helps to access the larynx in children with MS.