International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · May 2007
Randomized Controlled TrialKetamine in post-tonsillectomy pain.
There has yet been no ideal method for postoperative analgesia in children. Ketamine demonstrates a potent analgesic effect by central blockage of perception of pain with sub-anesthetic doses. Preoperative intramuscular administration of ketamine for sedation decreases the pain during swallowing after tonsillectomy, while it provides long-term analgesia when applied around the incision. The aim of this study is to compare the effectiveness of ketamine administered to the tonsillar region following tonsillectomy for postoperative pain management. ⋯ In previous studies, no significant differences were demonstrated in pre-emptive analgesia with ketamine, magnesium, morphine, and clonidine. The dose of ketamin and the volume used in this study caused no sedation or nausea and provided a high level of analgesia. Ketamine infiltration into the tonsillar region after tonsillectomy was found to be easy and effective.
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Int. J. Pediatr. Otorhinolaryngol. · Apr 2007
The nasopharyngeal prong airway: an effective post-operative adjunct after adenotonsillectomy for obstructive sleep apnoea in children.
Obstructive sleep apnoea is a common childhood disorder. Adenotonsillar enlargement is most commonly implicated, with adenotonsillectomy representing an effective treatment in the majority of cases. Such children may develop respiratory compromise post-operatively, sometimes necessitating admission to the intensive care unit. We describe insertion of a nasopharyngeal "prong" airway and evaluate its benefits after adenotonsillectomy for obstructive sleep apnoea and milder forms of sleep-disordered breathing. ⋯ Use of a nasopharyngeal prong significantly improves the post-operative course of selected children who are at high risk of respiratory compromise after adenotonsillectomy. This largely avoids the need for medical intervention and intensive care admission.
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Int. J. Pediatr. Otorhinolaryngol. · Mar 2007
Evaluation of the Parental Perspective instrument for pediatric cochlear implantation to arrive at a short version.
Evaluation of the well-known and widely used Parental Perspectives questionnaire (PP) by means of statistical analysis and exploring the possibility to develop a short version, as the instrument is often regarded as being rather lengthy with 74 questions. ⋯ The Parental Perspectives instrument (PP) is an important tool to assess the impact of cochlear implantation of a child for the quality of life for the family and the child itself. This statistical investigation showed a possible option for development of a short form usable in prospective follow-up studies.
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Int. J. Pediatr. Otorhinolaryngol. · Mar 2007
The management of general and disease specific ENT problems in children with Epidermolysis Bullosa--a retrospective case note review.
Epidermolysis Bullosa encompasses a group of inherited disorders characterized by excessive susceptibility of the skin and mucosa to separate from underlying tissues following mechanical trauma. Information in the literature and guidance on the management of Ear, Nose and Throat problems in such children is scarce. The aim of this study is to report the experience of an Ear, Nose and Throat department in a tertiary paediatric hospital linked to a national Epidermolysis Bullosa unit, describing how children have presented and the care that has been given including a theatre protocol aimed at reducing shearing forces. ⋯ Optimal management depends on the support of a multidisciplinary team, including otolaryngologists, pediatricians, dermatologists, anaesthetists, and specialist nurses. Adherence to a protocol for theatre management can help avoid intraoperative complications.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2007
Late diagnosis of foreign body aspiration in children with chronic respiratory symptoms.
Children with undiagnosed and retained foreign bodies (FBs) may present with persistent respiratory symptoms. Delayed diagnosis is an important problem in developing countries and several factors affect the delay. ⋯ Atypical or prolonged respiratory symptoms should alert the physician and clinical and radiological findings should be carefully evaluated for a possible FBA. Delay in diagnosis and treatment of FBA should be avoided to prevent complications.