Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2007
Children who refuse anesthesia or sedation: a survey of anesthesiologists.
Few articles have addressed the issue of the child who refuses anesthesia or sedation for surgery. A survey of members of the Society for Pediatric Anesthesia in the USA was conducted regarding their experience with pediatric refusal and assent for surgery. ⋯ Cancellation of planned surgery because of child refusal is not uncommon. It is important to recognize the potentially uncooperative child, particularly older children with developmental delay or a lack of understanding. Discussion with child and parents, selective use of premedication and different induction agents, distraction, play techniques, gentle restraint and the option of cancellation and review should all be considered.
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Paediatric anaesthesia · Dec 2007
The use of dexmedetomidine during laryngoscopy, bronchoscopy, and tracheal extubation following tracheal reconstruction.
We report the use of dexmedetomidine for laryngoscopy, rigid bronchoscopy, and tracheal extubation in the operating room in two children who had undergone tracheal reconstruction 1 week previously. Dexmedetomidine in combination with propofol provided appropriately deep anesthesia during these brief but stimulating procedures without cardiovascular or respiratory depression.
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Paediatric anaesthesia · Dec 2007
Randomized Controlled Trial Comparative StudyThe optimum initial pediatric epidural bolus: a comparison of four local anesthetic solutions.
There is no consensus on the concentration or type of local anesthetic used for initiation of epidural anesthesia. The aim of this randomized, double-blind, controlled trial was to compare the clinical effectiveness of epidural administration of both levobupivacaine and bupivacaine in 0.2% and 0.25% concentrations in pediatric patients undergoing abdominal and urological surgery. ⋯ While there is no difference in the proportion of effective surgical anesthesia, the lower incidence of pain and distress with the 0.25% solutions suggests that this concentration has clinical advantages over the 0.2% solutions for pediatric epidural anesthesia.
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Paediatric anaesthesia · Dec 2007
Randomized Controlled Trial Comparative StudyPremedication in children: a comparison of oral midazolam and oral clonidine.
Oral premedication is widely used in pediatric anesthesia to reduce preoperative anxiety and ensure smooth induction. Midazolam is currently the most commonly used premedicant, but good results have also been reported with clonidine. The aim of the present study was to compare clinical effects of oral midazolam and oral clonidine. ⋯ In this study, premedication with oral clonidine appeared to be superior to oral midazolam. Quality of mask acceptance was comparable between groups, but oral clonidine was better accepted by the child, produced more effective preoperative sedation, showed a trend towards better recovery from anesthesia and had a higher degree of parental satisfaction.
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Paediatric anaesthesia · Dec 2007
Clinical TrialStudy of the adjustment of the Ambu laryngeal mask under magnetic resonance imaging.
Our aim in this study was to analyze the adjustment of the laryngeal mask, Ambu AuraOnce, in pediatric patients during magnetic resonance imaging (MRI) and to look for a correlation between clinical parameters such as the sealing pressure and the ease of introduction with radiological parameters. ⋯ The Ambu AuraOnce can be regarded as a safe product for airway maintenance in pediatric patients. No relationship was found between radiological measurements and sealing pressures.