Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2006
Randomized Controlled Trial Comparative StudyEmergence agitation in preschool children: double-blind, randomized, controlled trial comparing sevoflurane and isoflurane anesthesia.
This randomized, double-blind controlled trial was conducted to determine whether the association of sevoflurane for induction and isoflurane for anesthesia maintenance resulted in a lower incidence of postoperative agitation compared with sevoflurane as single agent. ⋯ The association of sevoflurane for induction and isoflurane for maintenance produced significant less postoperative agitation in preschool children receiving regional anesthesia during subumbilical surgery compared with sevoflurane for induction and maintenance.
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Paediatric anaesthesia · Nov 2006
Randomized Controlled TrialSafe removal of LMA in children - at what BIS?
Removal of an LMA without producing untoward complications has remained a matter of concern to all anesthesiologists; more so in pediatric practice where the margin of safety is narrow. Most work on LMA in adults supports its removal following return of airway reflexes. The situation regarding its removal in children is, however, less clear. ⋯ Bispectral index scoring should prove a useful adjunct to the present monitoring and can be used to achieve smoother emergence conditions. We suggest that LMA removal should be attempted in children when a BIS value of approximately 60 is reached.
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Paediatric anaesthesia · Nov 2006
ReviewUltrasonographic guidance in pediatric regional anesthesia. Part 2: techniques.
The benefits of regional anesthesia are well documented. The downsides of such techniques have been a significant failure rate and a potential for serious complications. Nearly, all regional blocks were first described as essentially 'blind' techniques. ⋯ Improved understanding of sonographic anatomy should lessen both the failure rate and the possibility of incurring serious complications. Natural caution has dictated that only a selection of blocks used in adults has been commonly used in pediatric practice, but with the aid of US, the repertoire of blocks for infants and children may be widened. The second part of this review will concentrate on the practice of both peripheral and central blocks.
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Paediatric anaesthesia · Nov 2006
Case ReportsCardiac arrest at induction of anesthesia in a child with undiagnosed right-ventricular dependent coronary circulation: a case report.
Pediatric perioperative cardiac arrest occurs in 1.4 per 10,000 anesthetics, with an overall mortality rate of 26%. The etiology of the arrest is identifiable in the majority of these patients. We report the case of a child with a complex congenital heart defect, who sustained a cardiac arrest at induction of anesthesia, secondary to right-ventricular dependent coronary circulation. We discuss the incidence, risks, anesthetic management and outcomes of pediatric cardiac arrest in the perioperative period especially in patients with complex congenital heart disease.
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Paediatric anaesthesia · Nov 2006
Case ReportsAnesthesia management for the child with Sanjad-Sakati syndrome.
Sanjad-Sakati syndrome (SSS) is a rare genetic disorder characterized by congenital hypoparathyroidism, hypocalcemia and hyperphosphatemia, seizures, severe intrauterine and postnatal growth failure, dwarfism, mental retardation, dysmorphic features including retromicrognathia and abnormal dentition and increased susceptibility to infection. It is mainly confined to children in the Middle-East countries. We report the anesthesia management of a 12-year-old boy with SSS for dental treatment, and discuss the anesthesia implications of this disorder.