Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2007
Comparative StudyA comparison of parents and pediatric anesthesiologists' preferences for attributes of child daycase surgery: a discrete choice experiment.
Currently, there is little evidence relating to which attributes of pediatric daycase surgery are most important to parents; therefore, it is difficult for policy-makers in the UK to incorporate parents' preferences into pediatric daycase service provision. Additionally, few studies have considered anesthesiologists' preferences in this area. Parents and anesthesiologists' preferences for perioperative care of children undergoing daycase surgery may differ and this could affect levels of satisfaction with service provision. This study aimed to elicit and compare the relative importance of attributes of pediatric daycase surgery provision to parents and anesthesiologists using an established stated preference method, the discrete choice experiment. The attributes considered were: parental involvement in medical decision making; parental presence at induction of anaesthesia; quality of recovery from anaesthesia; staff attitude; postoperative pain and cost to the parents. ⋯ Parents and anesthesiologists had a significantly different order of priorities for service attributes.
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Paediatric anaesthesia · Nov 2007
Combined spinal-epidural anesthesia in major abdominal surgery in high-risk neonates and infants.
Combined spinal-epidural anesthesia (CSE-A) is reportedly safe and effective for the pediatric population in infraumbilical surgery. Our main purpose was to describe our experience of this technique in neonates and infants undergoing elective major upper abdominal surgery. ⋯ Combined spinal-epidural anesthesia could be considered as an effective anesthetic technique for elective major upper abdominal surgery in awake or sedated neonates and infants, and could be used cautiously by a pediatric anesthesiologist as an alternate to general anesthesia in high-risk neonates and infants undergoing upper gastrointestinal surgery.
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Paediatric anaesthesia · Nov 2007
Maturational pharmacokinetics of single intravenous bolus of propofol.
Our aim was to document propofol pharmacokinetics in preterm and term neonates following a single intravenous bolus and compare these estimates with pharmacokinetics findings in toddlers and young children. ⋯ Propofol disposition is significantly different in neonates compared with toddlers and young children, reflecting both ontogeny and differences in body composition. Based on the reduced clearance of propofol, a longer recovery time is more likely to occur in neonates.