Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2006
Randomized Controlled Trial Comparative StudyDistraction with a hand-held video game reduces pediatric preoperative anxiety.
Video games have received widespread application in health care for distraction and behavior modification therapy. Studies on the effect of cognitive distraction during the preoperative period are lacking. We evaluated the efficacy of an interactive distraction, a hand-held video game (VG) in reducing preoperative anxiety in children. ⋯ A hand-held VG can be offered to most children as a low cost, easy to implement, portable, and effective method to reduce anxiety in the preoperative area and during induction of anesthesia. Distraction in a pleasurable and familiar activity provides anxiety relief, probably through cognitive and motor absorption.
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Paediatric anaesthesia · Oct 2006
Review Historical ArticleUltrasonographic guidance in pediatric regional anesthesia Part 1: Theoretical background.
Recent findings support the use of ultrasonographic guidance in pediatric regional anesthesia. This review article illustrates basic knowledge in physics of ultrasound and ultrasonographic appearance of neuronal structures, which are prerequisites for the safe application of this technique in daily clinical practice. A critical view on education and ethics in science should emphasize future developments in ultrasonography for pediatric regional anesthesia.
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Paediatric anaesthesia · Oct 2006
Comparative StudyTraining for neonatal resuscitation with the laryngeal mask airway: a comparison of the LMA-ProSeal and the LMA-Classic in an airway management manikin.
Neonatal resuscitation is a mandatory skill for healthcare professionals involved in maternity suites. For ethical reasons, it is impossible to teach and practice airway management skills on neonates, and manikins are used for this purpose. The Classic Laryngeal Mask Airway TM (cLMA) is accepted as an effective device for airway management during neonatal resuscitation. A neonatal size of the LMA-ProSeal (PLMA) was recently produced, but there are no comparative data on its performance. We describe the comparison of the performances of the neonatal cLMA and the neonatal PLMA when used by different healthcare professionals in a dedicated airway management manikin. ⋯ Both LMAs are easy to insert by different delivery-room workers. PLMA (with the introducer tool) has a higher success rate at first attempt than cLMA. Manikin ventilation was established equally without difference in performance among doctors, nurses, midwives. A brief manikin-training reduces the IT significantly. The longer IT of PLMA vs cLMA is without clinical relevance.
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Paediatric anaesthesia · Oct 2006
Case ReportsAnesthesia in a child with newly diagnosed Hypertrophic Cardiomyopathy.
We report the initial resuscitation and subsequent management of a child with newly diagnosed Hypertrophic Cardiomyopathy (HCM), which presented as an out of hospital cardiac arrest. HCM is an autosomal dominant condition that is uncommonly encountered in the pediatric setting and is an important cause of sudden death. Here, we describe the safe use of an anesthetic technique for insertion of an implantable cardioverter-defibrillator that ensured strict hemodynamic stability and modest bradycardia.
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Paediatric anaesthesia · Oct 2006
Case ReportsRepeat episodes of severe muscle rigidity in a child receiving sevoflurane.
We report on a patient who developed two episodes of severe muscle rigidity, increased endtidal CO2 and increased creatine phosphate kinase associated with sevoflurane anesthesia. Dysrhythmias and hyperthermia were not observed and dantrolene was not administered. Genetic testing for the 17 known mutations associated with malignant hyperthermia (MH) was negative. Although we cannot rule out MH or other neuromuscular diseases we suggest that this rare event may be a direct effect of sevoflurane.