Journal of pediatric surgery
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Delivery of local anesthesia for surgical office procedures for pediatric patients can be difficult. Injections are painful and often lead to patient anxiety, and topical anesthetics frequently provide incomplete anesthesia. The authors prospectively studied the efficacy of iontophoresis, a needle-free technique in which positively charged lidocaine and epinephrine molecules are drawn into the tissue by an electrical current as an anesthetic for pediatric surgical office procedures. ⋯ Iontophoresis appears to be an effective and safe alternative method of local anesthesia delivery for pediatric surgical office procedures.
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Burn care requires daily debridement, dressing changes, and assessment regarding the need for skin grafting. These procedures are painful and may require an operating room environment. ⋯ PS in burn patients allows for early aggressive debridement, decreases the use of the operating room for debridement, and a decrease in length of stay when compared with our previous burn patients. PS has a modest risk of complications, enhances the family's cooperation and satisfaction with health care provided, and should be an integral part of burn care in children.
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Blood perfusion to the coronary artery (CA) during venoarterial (VA) extracorporeal membrane oxygenation (ECMO) was examined to determine whether it was receiving highly oxygenated ECMO blood or desaturated blood from the pulmonary circulation of diseased lungs. ⋯ These results suggest that an excessive "lung rest" strategy during VA ECMO may produce suboptimal coronary oxygenation possibly leading to myocardial damage. The presence of a small left-to-right shunt may prevent coronary hypoxia.