Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2010
Randomized Controlled TrialEffects of intrathecal fentanyl on quality of spinal anesthesia in children undergoing inguinal hernia repair.
The effect of intrathecal fentanyl on the characteristics of spinal anesthesia has not been investigated in children undergoing inguinal hernia repair. The purpose of this study was to assess whether the incidence and severity of pain during peritoneal sac traction is decreased by addition of fentanyl to bupivacaine in children undergoing inguinal hernia repair with spinal anesthesia. ⋯ Intrathecal fentanyl at a dose of 0.2 microg.kg(-1) added to bupivacaine significantly improves the quality of intraoperative analgesia and prolongs postoperative analgesia in children undergoing inguinal hernia repair with spinal anesthesia.
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Paediatric anaesthesia · Jun 2010
Comparative StudyA comparison of bonfils fiberscope-assisted laryngoscopy and standard direct laryngoscopy in simulated difficult pediatric intubation: a manikin study.
Difficult airway management in children is challenging. One alternative device to the gold standard of direct laryngoscopy is the STORZ Bonfils fiberscope (Karl Storz Endoscopy, Tuttlingen, Germany), a rigid fiberoptic stylette-like scope with a curved tip. Although results in adults have been encouraging, reports regarding its use in children have been conflicting. We compared the effectiveness of a standard laryngoscope to the Bonfils fiberscope in a simulated difficult infant airway. ⋯ The Bonfils fiberscope-assisted laryngoscopy was easier to use and provided a better view of the larynx than simple direct laryngoscopy in the simulated difficult pediatric airway, but intubation success rate and time to intubate were not improved. Further studies of the Bonfils fibrescope as a pediatric airway adjunct are needed.
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Paediatric anaesthesia · Jun 2010
Influence of external cardiac pacing on cerebral oxygenation measured by near-infrared spectroscopy in children after cardiac surgery.
The brain of children in the early period after repair of congenital heart defects with cardiopulmonary bypass (CPB) may be more vulnerable to hemodynamic changes because of impaired cerebral autoregulation. During postoperative testing of the external temporary safety pacer, we performed desynchronizing ventricular pacing (VVI) while monitoring cerebral oxygenation using near-infrared spectroscopy (NIRS). ⋯ Cardiac desynchronization after CPB seems to reduce CBF and cerebral oxygenation in children.
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Paediatric anaesthesia · Jun 2010
Effect of increasing depth of dexmedetomidine anesthesia on upper airway morphology in children.
This prospective study examines the dose-response effects of dexmedetomidine on upper airway morphology in children with no obstructive sleep apnea (OSA). ⋯ Upper airway changes associated with increasing doses of dexmedetomidine in children with no OSA are small in magnitude and do not appear to be associated with clinical signs of airway obstruction. Even though these changes are small, all precautions to manage airway obstruction should be taken when dexmedetomidine is used for sedation.