Minnesota medicine
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This article presents a cohort review of anesthesia-related perioperative outcomes of children undergoing ambulatory urologic surgery using a combination of general and regional anesthesia. We analyzed the charts of 123 patients who underwent hypospadias repair and circumcision between July 1,2006, and January 2, 2009, for cases of postoperative nausea and vomiting. We found the incidence to be quite low. We believe the low incidence may have been related to the prophylactic use of antiemetics along with an opioid-sparing technique for anesthesia care.
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Providing procedural sedation for pediatric patients presents unique challenges. Children's hospitals have protocols in place to provide safe, high-quality sedation care delivered by specialists in pediatric sedation and anesthesiology. ⋯ This article describes some of the key components involved in establishing a protocol for safe and effective pediatric sedation services including screening techniques for patients at higher risk for complications and appropriate monitoring and rescue plans. We also review medications commonly used for pediatric sedation and pain management and discuss resources available to physicians who provide pediatric sedation.
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Comparative Study
Discomfort, delirium, and PONV in infants and young children undergoing strabismus surgery.
This article presents the results of a retrospective analysis of anesthesia care and perioperative outcomes in children up to 2 years of age who underwent strabismus surgery during a five-year period at the University of Minnesota Amplatz Children's Hospital. We reviewed the charts of 74 children to determine perioperative outcomes--namely discomfort, emergence agitation/delirium, and postoperative nausea and vomiting (PONV). We found that although PONV was not an issue in this age group, as it was with older children, discomfort and emergence agitation/delirium do need to be considered during their care.