Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2006
The clinical observation of difficult laryngoscopy and difficult intubation in infants with cleft lip and palate.
The aims of this study were to evaluate the incidence of difficult laryngoscopy in infants with cleft lip and palate and to observe its relationships with age, sites, and degrees of deformities. ⋯ Infants with cleft lip and palate, left cleft lip and alveolus, combined bilateral cleft lip and palate, micrognathia, and age <6 months were the important risk factors for difficult laryngoscopy. Difficult intubation occurred mainly in infants with laryngoscopic views of grade III and IV.
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Paediatric anaesthesia · Mar 2006
Case ReportsUltrasound-guided interscalene brachial plexus block in a child with femur fibula ulna syndrome.
Ultrasound-guided interscalene brachial plexus block is described in a 7-year-old child with femur fibula ulna syndrome. It is suggested that ultrasound is a useful tool in situations where nerve stimulation for nerve localization cannot be used.
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Anesthesia and the operating theater environment is a complex system involving man-machine and human-human interactions. Although we strive for an error free system, we are humans and errors and mistakes will occur. The aim of this study was to investigate the human factors behind events and incidents in pediatric anesthesia at our institution. ⋯ In our institution anesthetic human factors occur in 42.5% of in-theater incidents in pediatric anesthesia. Knowledge of these is necessary so that changes can be made in practice both by individuals and departments of anesthesia, to make anesthesia as safe as possible.
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Paediatric anaesthesia · Mar 2006
Age and size are the major covariates for prediction of levobupivacaine clearance in children.
We aimed to identify and quantify major factors describing the variability of levobupivacaine clearance in children. ⋯ Size and PNA are the major contributors to clearance variability in children. These covariates should be considered when establishing safe epidural infusion regimens. Reduced clearance and slower absorption half-time contribute to delayed T(max) in neonates and young infants.
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Paediatric anaesthesia · Mar 2006
Futility and inappropriate care in pediatric intensive care: a cross-sectional survey.
Over recent years, there have been increasing concerns regarding an increase in the number of futile and inappropriate admissions to pediatric intensive care units (PICUs) in the United Kingdom (UK). ⋯ The care being provided in 21% of the PICU cases, described in this study, was felt to be either futile or inappropriate by the directors of those units. There is an urgent need to, accurately, establish the resource consumption associated with these patients and to establish a standard approach to futility and inappropriate care in PICU in the UK.