Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2010
ReviewAnesthetic considerations for the pediatric oncology patient--part 1: a review of antitumor therapy.
The anesthesiologist who cares for children with cancer or for survivors of childhood cancer should possess a basic understanding of cancer treatment. While this is an ever-changing field, a basic knowledge of chemotherapeutic drugs, radiation therapy, and the toxicities of each is necessary to prepare a safe anesthetic plan. ⋯ This article, which is the first of a three-part review series, will review current principles of cancer therapy and the general mechanisms of toxicity to the child. Although this article is not intended to comprehensively review the fundamentals of chemotherapy and radiation therapy, the consequences of anticancer therapy that impact perioperative care and decision making are presented for the anesthesiologist.
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Paediatric anaesthesia · Apr 2010
A new approach for peri-operative analgesia of cleft palate repair in infants: the bilateral suprazygomatic maxillary nerve block.
Congenital cleft palate (CP) is a common and painful surgical procedure in infants. CP repair is associated with the risk of postoperative airway obstruction, which may be increased with administration of opioids, often needed for analgesia. No described regional anesthesia technique can provide adequate pain control following CP repair in infants. The primary aim of this prospective and descriptive study was to observe the effectiveness of bilateral maxillary nerve blocks (BMB) using a suprazygomatic approach on pain relief and consumption of rescue analgesics following CP repair in infants. Analgesic consumption was compared to retrospective data. Complications related to this new technique in infants were also reviewed. ⋯ BMB using a suprazygomatic approach seems to improve pain relief, to decrease peri-operative consumption of opioids, and to favor early feeding resumption after CP repair in infants.
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Paediatric anaesthesia · Apr 2010
Protective ventilation to reduce inflammatory injury from one lung ventilation in a piglet model.
To test the hypothesis that protective ventilation strategy (PVS) as defined by the use of low stretch ventilation (tidal volume of 5 ml x kg(-1) and employing 5 cm of positive end expiratory pressure (PEEP) during one lung ventilation (OLV) in piglets would result in reduced injury compared to a control group of piglets who received the conventional ventilation (tidal volume of 10 ml x kg(-1) and no PEEP). ⋯ Based on this model, PVS decreases inflammatory injury both systemically and in the lung tissue with no adverse effect on oxygenation, ventilation, or lung function.
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OBJECTIVES & AIM: The purpose of this investigation was to examine children's anxiety across the perioperative setting. ⋯ Identification and prevention of anxiety in children can help prevent negative outcomes following surgery.
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Paediatric anaesthesia · Apr 2010
An allometric model to estimate fluid requirements in children following burn injury.
To evaluate the ability of an allometric 3/4 Power Model combined with the Galveston Formula (Galveston-3/4 PM Formula) to predict fluid resuscitation requirements in children suffering burn injuries in comparison with the frequently used Parkland Formula and Galveston Formula using the Du Bois formula for surface area estimation (Galveston-DB Formula). ⋯ For the purposes of clinical estimation of fluid requirements, the Galveston-3/4 PM Formula is indistinguishable from the Galveston-DB Formula in children 23 kg or less.