Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2010
Randomized Controlled TrialSlower administration of propofol preserves adequate respiration in children.
Propofol is a versatile anesthetic agent used in pediatric practice to facilitate investigational and interventional procedures. Propofol can cause significant respiratory depression, the management of which may require advanced airway management skills. This investigation aimed to increase the safety of propofol administration by developing a dosing schedule that would preserve spontaneous respiration in at least 95% of subjects. ⋯ The respiratory response to propofol is highly variable in children. Slower infusion of propofol will result in a lower risk of respiratory depression.
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Paediatric anaesthesia · Nov 2010
Multicenter StudyA novel isotonic-balanced electrolyte solution with 1% glucose for intraoperative fluid therapy in children: results of a prospective multicentre observational post-authorization safety study (PASS).
The recommendations for intraoperative fluid therapy in children have been adapted from hypotonic to isotonic electrolyte solutions with lower glucose concentrations (1-2.5% instead of 5%) to avoid hyponatremia and hyperglycemia. ⋯ The studied isotonic-balanced electrolyte solution with 1% glucose helps to avoid perioperative acid-base imbalance, hyponatremia, hyperglycemia, and ketoacidosis in infants and toddlers and may therefore enhance patient safety.
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Paediatric anaesthesia · Nov 2010
Randomized Controlled TrialThe effect of volume of local anesthetic on the anatomic spread of caudal block in children aged 1-7 years.
To examine the anatomic spread of caudal local anesthetic solution in children aged 1-7 years. ⋯ Incrementally increasing the volume of injectate between 0.5 and 1.0 results in a modest increase in the spread of the caudal solution. It is unlikely that volumes of <1 ml will reliably reach a vertebral level that is higher than L2.
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Paediatric anaesthesia · Nov 2010
Cerebral NIRS as a marker of superior vena cava oxygen saturation in neonates with congenital heart disease.
To investigate the correlation between cerebral near-infrared spectroscopy (NIRS) (rSO2c) and superior vena cava venous oxygen saturation (ScvO2) in newborn patients with congenital heart disease (CHD). ⋯ rSO2c in newborn patients with cyanotic and acyanotic CHD provides a continuous noninvasive information with a fair correlation with ScvO2%: some predictable variables (i.e., time from surgery, carbon dioxide, and venous saturation levels), should guide the operators to adjust rSO2c values in terms of ScvO2. Serial measures of ScvO2 seem recommended to tailor rSO2c information on actual venous saturation percentage.
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Spinal anesthesia is underutilized for surgery in children in Nigeria. Until recently, only caudal and general anesthesia are employed in the pediatric age group, and the thought of spinal anesthesia was an anathema. This study evaluated cardiovascular changes, duration of spinal block, the length of surgery, length of spinal needle to establish lumbar puncture, and the incidence of complications associated with this procedure. ⋯ This study demonstrates that spinal anesthesia in children causes minimal hemodynamic disruption and therefore is a safe technique for lower extremity surgeries. This technique that hitherto has not been popular with children in our environment has been found to be safe and equally effective.