Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2009
Meta AnalysisDexmedetomidine pharmacokinetics in pediatric intensive care--a pooled analysis.
Published dexmedetomidine pharmacokinetic studies in children are limited by participant numbers and restricted pathology. Pooling the available studies allows investigation of covariate effects. ⋯ The sedation target concentration is similar to that described for adults. Immature clearance in the first year of life and a higher clearance (when expressed as l x h(-1) x kg(-1)) in small children dictate infusion rates that change with age. Extrapolation of dose from children given infusion in intensive care after cardiac surgery may not be applicable to those sedated for noninvasive procedures out of intensive care.
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Paediatric anaesthesia · Nov 2009
Randomized Controlled Trial Comparative StudyEfficacy of a low-dose spinal morphine with bupivacaine for postoperative analgesia in children undergoing hypospadias repair.
Children undergoing hypospadias repair need to be protected from highly unpleasant sensory and emotional experiences during and after surgery. We designed a double-blinded, randomized, and placebo-controlled study to compare the efficacy of a low-dose (2 microg x kg(-1)) of intrathecal morphine with placebo for postoperative pain control of children undergoing repair of hypospadias surgery with spinal anesthesia. ⋯ Spinal anesthesia provided by hyperbaric bupivacaine is adequate for distal hypospadias repair in children, but adding 2 microg x kg(-1) intrathecal morphine provides better postoperative pain control when compared to placebo in these children.
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Paediatric anaesthesia · Nov 2009
Randomized Controlled Trial Comparative StudyA comparison of the STORZ video laryngoscope and standard direct laryngoscopy for intubation in the Pediatric airway--a randomized clinical trial.
Direct laryngoscopy can be challenging in infants and neonates. Even with an optimal line of sight to the glottic opening, the viewing angle has been measured at 15 degrees . The STORZ DCI video laryngoscope (Karl Storz, Tuttlingen, Germany) incorporates a fiberoptic camera in the light source of a standard laryngoscope of variable sizes. The image is displayed on a screen with a viewing angle of 80 degrees . We studied the effectiveness of the STORZ DCI as an airway tool compared to standard direct laryngoscopy in children with normal airway. ⋯ This study demonstrates that the STORZ DCI video laryngoscope provides an improved view to the glottis in children with normal airway anatomy, but requires a longer time for intubation.
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Paediatric anaesthesia · Nov 2009
Randomized Controlled TrialAcupuncture management of pain and emergence agitation in children after bilateral myringotomy and tympanostomy tube insertion.
To further investigate the effect of acupuncture in postoperative pain and emergence agitation in children undergoing bilateral myringotomy and tympanostomy tube (BMT) placement. ⋯ Our study suggests that acupuncture therapy may be effective in diminishing both pain and emergence agitation in children after BMT insertion without adverse effects.
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Paediatric anaesthesia · Nov 2009
Randomized Controlled Trial Comparative StudyComparison of the Cobalt Glidescope video laryngoscope with conventional laryngoscopy in simulated normal and difficult infant airways.
To evaluate the new pediatric Glidescope (Cobalt GVL Stat) by assessing the time taken to tracheal intubation under normal and difficult intubation conditions. We hypothesized that the Glidescope would perform as well as conventional laryngoscopy. ⋯ The new Glidescope performs as well as the Miller laryngoscope under simulated normal and difficult airway conditions.