Paediatric anaesthesia
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We aimed to produce a racemic ketamine manual infusion regimen capable of maintaining a steady-state blood concentration associated with anesthesia in children aged 1.5-12 years. ⋯ Children require higher infusion rates than adults to maintain steady-state concentrations of 3 mg.l(-1) and have shorter context sensitive half-times than adults after prolonged infusion. These differences can be attributed to age-related pharmacokinetics. We anticipate slow return to full consciousness after prolonged infusion, suggesting that a lower target concentration with supplementation from adjuvant short acting anesthetic drugs may be advantageous.
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Paediatric anaesthesia · Aug 2008
Randomized Controlled Trial Comparative StudyComparison of sevoflurane and ketamine for anesthetic induction in children with congenital heart disease.
Sevoflurane is widely used in pediatric anesthesia for induction. Ketamine has been preferred in pediatric cardiovascular anesthesia. Aim of this study was to compare the hemodynamic effects and the speed of ketamine and sevoflurane for anesthesia induction in children with congenital heart disease. ⋯ Ketamine appears a good alternative for induction in patients with congenital heart disease. It permits preservation of hemodynamic stability with minimal side effects.
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Paediatric anaesthesia · Aug 2008
Randomized Controlled TrialRemifentanil for percutaneous intravenous central catheter placement in preterm infant: a randomized controlled trial.
There is limited evidence on the analgesic efficacy of opioids during percutaneous intravenous central catheter (PICC) insertion in preterm infants. ⋯ Low-dose remifentanil has a measurable, synergic analgesic effect in combination with 12% sucrose and non-nutritive sucking, but does not make PICC easier or quicker.
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Paediatric anaesthesia · Aug 2008
ReviewContinuing medical education in pediatric anesthesia--a theoretical overview.
The importance of continuing medical education (CME) as a method of improving the quality of care of children undergoing anesthesia is universally recognized. This article, which is based on a presentation at the FEAPA European Conference on Paediatric Anaesthesia in September 2007 in Amsterdam, gives a theoretical overview of continuing education and introduces some generic educational concepts, such as the CRISIS-criteria and Kirkpatrick's evaluation model, which are as relevant to pediatric anesthesia as to other areas of medical practice. ⋯ Some consideration is given to how anesthesiologists can assess the potential worth of an educational activity for their practice. No attempt will be made to judge particular educational activities, as the choice of the most appropriate activity rests primarily with the individual.
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Paediatric anaesthesia · Aug 2008
Randomized Controlled TrialDexmedetomidine disposition in children: a population analysis.
There are few data describing dexmedetomidine population pharmacokinetics (PK) in children (0-15 years) despite increasing use. ⋯ Clearance in neonates is approximately one-third of that described in adults, consistent with immature elimination pathways. Maintenance dosing, which is a function of clearance, should be reduced in neonates and infants when using a target concentration approach.