Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2006
An assessment of interrater reliability of the ASA physical status classification in pediatric surgical patients.
The American Society of Anesthesiologists physical status classification (ASA-PS) is used worldwide by anesthesia providers as an assessment of the preoperative physical status of patients. This assessment score has been inconsistently assigned by anesthesia providers among adult surgical patients. This study tested the reliability of assignment of ASA-PS classification among pediatric anesthesia providers. ⋯ These findings suggest a moderate agreement among pediatric anesthesia providers in assigning ASA-PS classification to selected pediatric case scenarios. Most disagreement, however, represented a tendency of outside care providers to assign a higher ASA physical status for cases. Furthermore, agreement was excellent for low risk (i.e. ASA I and II) as well as high risk (ASA III and IV) cases.
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Paediatric anaesthesia · Sep 2006
Clinical TrialRisk factors for anxiety at induction of anesthesia in children: a prospective cohort study.
In children anxiety at induction of anesthesia is a common and important aspect of the psychological impact of anesthesia and surgery. Previous studies examining risk factors for increased anxiety have found contradictory results. This may be due to using small, or highly selective population samples, or failure to adjust for confounding variables. Results may also be culturally or institutionally specific. The aim of this study was to identify possible risk factors in a large representative cohort of children. ⋯ Some simple preoperative questions can help identify children at risk of heightened anxiety at induction of anesthesia; however, it remains difficult to precisely predict which child will experience high anxiety.
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Paediatric anaesthesia · Sep 2006
ReviewHead and neck blocks in children: an anatomical and procedural review.
Children undergo a variety of neurosurgical, otorhinolaryngology and plastic surgery procedures to the head and neck. Although opioids are utilized for pain control, they are associated with adverse side effects including postoperative nausea and vomiting, respiratory depression, somnolence and itching. The utilization of peripheral nerve blocks provides analgesia while reducing the need for opioids. This review will provide a summary of a variety of commonly used head and neck nerve blocks in children with a brief anatomical and technical summary.
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Paediatric anaesthesia · Sep 2006
Randomized Controlled TrialEffect of an intravenous single dose of ketamine on postoperative pain in tonsillectomy patients.
Tonsillectomy has a high incidence of postoperative pain. The aim of the present study was to determine whether the use of low-dose IV ketamine, before the start of surgery or after the end of the operation, would lead to significantly improved pain control after tonsillectomy in pediatric patients. ⋯ The use of a single small dose of ketamine in a pediatric population undergoing tonsillectomy could reduce the frequency or even avoid the use of rescue analgesia in the postoperative period independent of whether used before or after the surgical procedure.