Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2017
Multicenter StudySuccess rate of pneumatic reduction of intussusception with and without sedation.
Pneumatic reduction of ileocolic intussusception is often performed without sedation. The aim of this study was to evaluate the success rate of pneumatic reduction of intussusception with and without sedation. ⋯ The findings suggest that the pneumatic reduction of intussusception under propofol-based sedation had a slightly higher success rate than the pneumatic reduction of intussusception without sedation; however, the safety of this practice is yet to be determined.
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Paediatric anaesthesia · Jun 2016
Multicenter StudyPediatric preoperative risk factors to predict postoperative ICU admission and death from a multicenter retrospective study.
Although some studies have investigated the potential predictors of perioperative mortality, there are few specifically for pediatrics. ⋯ Our study revealed that age, ASA physical status, SpO2 , prematurity, and unfasted status are risk factors to predict postoperative ICU admission and death in pediatric patients.
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Paediatric anaesthesia · Dec 2015
Multicenter Study Observational StudyThe prevalence of pain at home and its consequences in children following two types of short stay surgery: a multicenter observational cohort study.
The potential for pain at home in children following day case surgery has long been recognized. Pain has also been associated with behavioral disturbances and sleep disruption in children following surgery and may also impact negatively on recovery, parental and patient satisfaction, family life, healthcare use, and have an economic cost. ⋯ The prevalence of pain at home, and its potential associated consequences, is high following short stay surgery in children in the UK. In both groups, high incidences were seen for longer periods than is commonly perceived. These findings were consistent between the centers involved suggesting that this is a significant national healthcare issue with potential short- and long-term consequences for the child, their family, and health services.
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Paediatric anaesthesia · Aug 2015
Randomized Controlled Trial Multicenter Study Comparative StudyA randomized multi-institutional crossover comparison of the GlideScope(®) Cobalt Video laryngoscope to the flexible fiberoptic bronchoscope in a Pierre Robin manikin.
The GlideScope Cobalt Video laryngoscope is being used more often in children with challenging laryngoscopy. There are, however, no pediatric trials comparing it to flexible fiberoptic bronchoscopy, the current accepted gold standard. This preliminary manikin study compares the first-attempt intubation success of the GlideScope Cobalt video laryngoscope to the flexible fiberoptic bronchoscope when performed by attending pediatric anesthesiologists at two major pediatric centers. ⋯ There was no difference in first-attempt success of tracheal intubation using VL vs fiberoptic bronchoscopy when performed by attending anesthesiologists at two large pediatric centers. However, institutional differences exist in success rates with VL across the two centers. Results from single-center device evaluations should be verified by multi-center evaluations. A significant proportion of attending anesthesiologists lack experience with advanced airway devices; targeted education may enhance intubation success and patient safety.
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Paediatric anaesthesia · Nov 2014
Multicenter Study Observational StudyPain management following major intracranial surgery in pediatric patients: a prospective cohort study in three academic children's hospitals.
Pain management following major intracranial surgery is often limited by a presumed lack of need and a concern that opioids will adversely affect postoperative outcome and interfere with the neurologic examination. Nevertheless, evidence in adults is accumulating that these patients suffer moderate to severe pain, and this pain is often under-treated. The purpose of this prospective, clinical observational cohort study was to assess the incidence of pain, prescribed analgesics, methods of analgesic delivery, and patient/parent satisfaction in pediatric patients undergoing cranial surgery at three major university children's hospitals. ⋯ Despite considerable variation in modality and route of analgesic administration, there were no differences in average pain score, length of stay, or parental satisfaction with care. Pain scores were low, side effects were minimal, and parental satisfaction was high, providing equipoise for future blinded prospective randomized trials in this patient population.