Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2008
Randomized Controlled Trial Comparative StudyThe Proseal laryngeal mask airway in children: a comparison between two insertion techniques.
The Proseal laryngeal mask airway (PLMA) is a relatively new supraglottic airway device with a drain tube to minimize the risk of gastric insufflation and aspiration. We compared introducer tool (IT) and gum elastic bougie (GEB)-guided techniques for insertion of the Proseal LMA in children. ⋯ A gum elastic bougie-guided insertion technique in children is comparable with the IT technique in terms of success rate and may be useful as a backup technique when the IT technique fails.
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Paediatric anaesthesia · Feb 2008
Comparative Study Clinical TrialComparison of different near-infrared spectroscopic cerebral oxygenation indices with central venous and jugular venous oxygenation saturation in children.
We compared two different near-infrared spectrophotometers: cerebral tissue oxygenation index (TOI) measured by NIRO 200 and regional cerebral oxygenation index (rSO(2)) measured by INVOS 5100 with venous oxygen saturation in the jugular bulb (SjO(2)) and central SvO(2) from the superior caval vein (SVC) during elective cardiac catheterization in children. ⋯ Both near-infrared spectroscopy devices demonstrate a significant correlation with SjO(2) and SvO(2) values; nevertheless both devices demonstrate a substantial bias of the measurements to both SjO(2) and SvO(2).
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Paediatric anaesthesia · Feb 2008
Clinical TrialSafety and efficacy of patient controlled epidural analgesia following pediatric spinal surgery.
Patient controlled epidural analgesia (PCEA) is uncommon in pediatric anesthesia. Because PCEA offers superior pain control compared with continuous epidural infusions in adults, we prospectively evaluated the analgesia efficacy and safety of PCEA in children and adolescents following extensive spinal surgery. ⋯ The present study demonstrates that PCEA provides excellent pain relief following extensive spinal surgery and is associated with a low incidence of adverse events. The use of PCEA should be encouraged in children and adolescents following extensive spinal surgery.
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Aprotinin is a potent antifibrinolytic drug, which reduces postoperative bleeding and transfusion requirements. Recently, two observational studies reported increased incidence of renal dysfunction after aprotinin use in adults. Therefore, the aim of the study was to investigate the safety of aprotinin use in pediatric cardiac surgery patients. ⋯ Despite the higher incidences of renal dysfunction and failure in the aprotinin group, an independent role of the drug in the development of renal dysfunction or dialysis could not be demonstrated in pediatric cardiac patients undergoing CPB.
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Paediatric anaesthesia · Feb 2008
Clinical TrialMaternal heart rate variability just before surgery significantly correlated with emergence behavior of children undergoing general anesthesia.
Emergence agitation in pediatric anesthesia is associated with preanesthesia child anxiety, which is strongly influenced by maternal mental conditions. Mental stress affects the autonomic nervous system, thereby influencing heart rate variability (HRV). The present study tested the correlations between preanesthesia maternal HRV and perioperative child behavior. ⋯ Two-hour maternal HRV just before surgery significantly correlated with emergence behavior of children undergoing general anesthesia.