Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2008
Randomized Controlled Trial Comparative StudyComparison of sevoflurane and ketamine for anesthetic induction in children with congenital heart disease.
Sevoflurane is widely used in pediatric anesthesia for induction. Ketamine has been preferred in pediatric cardiovascular anesthesia. Aim of this study was to compare the hemodynamic effects and the speed of ketamine and sevoflurane for anesthesia induction in children with congenital heart disease. ⋯ Ketamine appears a good alternative for induction in patients with congenital heart disease. It permits preservation of hemodynamic stability with minimal side effects.
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Paediatric anaesthesia · Aug 2008
Randomized Controlled TrialRemifentanil for percutaneous intravenous central catheter placement in preterm infant: a randomized controlled trial.
There is limited evidence on the analgesic efficacy of opioids during percutaneous intravenous central catheter (PICC) insertion in preterm infants. ⋯ Low-dose remifentanil has a measurable, synergic analgesic effect in combination with 12% sucrose and non-nutritive sucking, but does not make PICC easier or quicker.
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Paediatric anaesthesia · Aug 2008
ReviewContinuing medical education in pediatric anesthesia--a theoretical overview.
The importance of continuing medical education (CME) as a method of improving the quality of care of children undergoing anesthesia is universally recognized. This article, which is based on a presentation at the FEAPA European Conference on Paediatric Anaesthesia in September 2007 in Amsterdam, gives a theoretical overview of continuing education and introduces some generic educational concepts, such as the CRISIS-criteria and Kirkpatrick's evaluation model, which are as relevant to pediatric anesthesia as to other areas of medical practice. ⋯ Some consideration is given to how anesthesiologists can assess the potential worth of an educational activity for their practice. No attempt will be made to judge particular educational activities, as the choice of the most appropriate activity rests primarily with the individual.
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Age influences the potency of anesthetic agents, but there is little information on how age influences MAC-awake. MAC-awake may be an important aspect of anesthesia potency for the prevention of awareness during anesthesia. The aim of this study was to measure MAC-awake in a range of ages in children. ⋯ Although MAC-awake changes with age, in the ages where awareness has been reported, MAC-awake was found to be relatively low, and therefore it seems unlikely that age-specific changes to MAC-awake are a cause for awareness in children aged 5-12 years.
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Paediatric anaesthesia · Aug 2008
Intraoperative extracorporeal membrane oxygenation and survival of pediatric patients undergoing repair of congenital heart disease.
We studied the association between the introduction of extracorporeal membrane oxygenation (ECMO) into routine practice and the survival of children who failed weaning from cardiopulmonary bypass (CPB). We compare two periods, before formal introduction of ECMO in our institution (1993-1999, pre-ECMO era) and after ECMO became a formalized program (2000-2006, ECMO era). ⋯ The availability of ECMO for neonates failing to wean from CPB was associated with improved survival, especially in children undergoing repair of the most complex congenital heart malformations. After introduction of ECMO, survival improved and no longer depended upon the complexity of surgical repair.