Paediatric anaesthesia
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Paediatric anaesthesia · May 2007
Randomized Controlled TrialLevel of sedation evaluation with Cerebral State Index and A-Line Arx in children undergoing diagnostic procedures.
Monitoring of anesthesia depth is difficult clinically, particularly in children. The aim of this study was to assess the correlation existing between CSI (Cerebral State Index), or AAI (A-line ARX) and a clinical sedation scale such as UMSS (University of Michigan Sedation Scale), during deep sedation with propofol in children undergoing diagnostic procedures. ⋯ Our study suggests that CSI and AAI may be two, real-time and objective tools to assess induction and emergence during propofol sedation in children undergoing EGDS and MRI.
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Paediatric anaesthesia · May 2007
Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality.
We aimed to improve the quality and safety of handover of patients from surgery to intensive care using the analogy of a Formula 1 pit stop and expertise from aviation. ⋯ The introduction of the new handover protocol lead to improvements in all aspects of the handover. Expertise from other industries can be extrapolated to improve patient safety, and in particular, areas of medicine involving the handover of patients or information.
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Paediatric anaesthesia · May 2007
Use of nonsteroidal anti-inflammatory drugs in infants. A survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used as perioperative analgesics. Many are currently used off label. Diclofenac is currently licensed for use in children over 1 year of age for the treatment of juvenile rheumatoid arthritis, while ibuprofen is licensed for use in children weighing over 7 kg. The dose and interval in children is currently extrapolated from adult studies, as the pharmacokinetic (PK) and pharmacodynamic (PD) data are lacking in infants. ⋯ Members of the Association of Paediatric Anaesthetists of Great Britain and Ireland commonly prescribe NSAIDs in infants. This is despite the dearth of PK and PD data in this age group.
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Paediatric anaesthesia · May 2007
Does bronchopulmonary dysplasia change the postoperative outcome of herniorrhaphy in premature babies?
Inguinal hernia is a common surgical condition in premature neonates. Because of physiological immaturity, they can present with lung-related diseases, such as bronchopulmonary dysplasia (BPD), which may influence the time for operation and the postoperative outcome after hernia repair. The aim of this study was to analyze the role of BPD in the outcome of premature infants who underwent herniorrhaphy. ⋯ These data suggest that all premature infants, with or without BPD, should be treated with equal concern regarding the possibility of postoperative pulmonary complications.
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Paediatric anaesthesia · May 2007
Postal survey of training in pediatric cardiac anesthesia in the United Kingdom.
There are no nationally agreed standards for training in pediatric cardiac anesthesia despite the recommendation of two reports. Since then, anesthesia training has changed because of the introduction of competency-based training, the New Deal and the European Working Time Directive. ⋯ They would recommend the same experience for others but this is unlikely to happen within the current constraints of specialist registrar training. Therefore, further training in a fellowship program in the UK or abroad is likely to be necessary.