Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2009
Randomized Controlled TrialReducing distress for children during invasive procedures: randomized clinical trial of effectiveness of the PediSedate.
Procedural pain control remains problematic for young children, especially during anxiety-causing procedures for which children should not be deeply sedated. The PediSedate was designed to address this problem by delivering nitrous oxide in oxygen through a simple nosepiece, combined with an interactive video component, so that children can use attention and distraction with drug delivery. ⋯ Previous studies have demonstrated the effectiveness of nitrous oxide sedation alone for minimizing pain and distress during invasive procedures. We have found that delivering nitrous oxide sedation via a system combined with an interactive video component is also effective. Further studies should determine which factors are dominant and determine the specific failure rate for this delivery system in comparison with other systems.
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Paediatric anaesthesia · Aug 2009
Experience of intravenous sedation for pediatric gastrointestinal endoscopy in a large tertiary referral center in a developing country.
The aim of this study was to evaluate the clinical efficacy of intravenous sedation for pediatric gastrointestinal endoscopy (GIE) at a tertiary care teaching hospital in a developing country. ⋯ In the setting of the developing country, intravenous sedation for pediatric GIE by trained anesthetic personnel with appropriate monitoring was safe and effective. Serious adverse events were rare in our population.
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Paediatric anaesthesia · Aug 2009
Comparative StudyCerebral metabolism during deep hypothermic circulatory arrest vs moderate hypothermic selective cerebral perfusion in a piglet model: a microdialysis study.
Few data exist regarding antegrade selective cerebral perfusion (ASCP) and its application in newborn and juvenile patients. Clinical data suggest ASCP alone to be superior to deep hypothermic circulatory arrest (DHCA); however, the effects of moderate hypothermia during ASCP on cerebral metabolism in this patient population are still unclear. ⋯ In this piglet model, both cerebral oxygenation and microdialysis findings suggested a depletion of cerebral energy stores during circulatory arrest in the DHCA18 group, compared to selective cerebral perfusion combined with circulatory arrest in the ASCP27 group.
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Paediatric anaesthesia · Aug 2009
Case ReportsAnesthetic management of a neonate with type IV laryngotracheo-esophageal cleft.
Laryngotracheo-esophageal cleft is a rare congenital anomaly that occurs when the trachea and esophagus fail to separate during fetal development. Clinical severity varies greatly in anatomic cleft extent. We report the successful management of the airway of a neonate with type IV laryngotracheo-esophageal cleft for the gastric division surgery by dividing the esophagogastric continuity between the esophageal orifice and the stomach using the balloon catheter and remaining spontaneous breathing through the large cuffed tracheal tube inserted into the esophageal orifice.