Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2007
Randomized Controlled Trial Comparative StudyProSeal as an alternative to endotracheal intubation in pediatric laparoscopy.
The increasing use of laparoscopic surgery in children mandates a leak-free airway device during carboperitoneum for which tracheal tubes (TT) have been traditionally used. The pediatric ProSeal is a recent introduction to the laryngeal mask airway (LMA) family. The ProSeal LMA (PLMA) has been successfully used in adult laparoscopic procedures. We hypothesized that the ProSeal can be equally effective in achieving adequate oropharyngeal seal and pulmonary ventilation during elective laparoscopic procedures in children. ⋯ The pediatric PLMA and TT have comparable ventilatory efficacy for elective short laparoscopic procedures.
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Paediatric anaesthesia · Apr 2007
Randomized Controlled Trial Comparative StudyProcedural sedation for insertion of central venous catheters in children: comparison of midazolam/fentanyl with midazolam/ketamine.
There is a lack of studies evaluating procedural sedation for insertion of central venous catheters (CVC) in pediatric patients in emergency departments or pediatric intensive care units (PICU). This study was designed to evaluate whether there is a difference in the total sedation time for CVC insertion in nonintubated children receiving two sedation regimens. ⋯ In this study of nonventilated children in PICU undergoing central line placement, M/F and M/K provided a clinically comparable total sedation time. However, the M/K sedation regimen was associated with a higher rate of minor complications. A longer period of study is required to assess the efficacy and safety of these sedative agents for PICU procedures in nonintubated children.
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Paediatric anaesthesia · Apr 2007
Randomized Controlled TrialMidazolam does not reduce emergence delirium after sevoflurane anesthesia in children.
Behavioral disturbance in children following sevoflurane anesthesia is a relatively frequent event. The aim of this study was to evaluate whether a higher dose of preoperatively administered rectal midazolam compared with a lower would alleviate this phenomenon. Furthermore the impact of these two doses of midazolam on sedation at induction of anesthesia was compared. ⋯ A higher dose of 1 mg.kg(-1) rectal midazolam results in much better sedated children on induction of anesthesia than 0.5 mg.kg(-1). This, however, does not result in a reduced incidence of emergence delirium after sevoflurane anesthesia. Regardless of the premedication negative behavioral changes occur more frequently in children younger than 3 years of age.