Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2011
Randomized Controlled TrialChildren on phenobarbital monotherapy requires more sedatives during MRI.
Phenobarbital induces specific hepatic cytochrome P-450 enzyme pathways causing increased clearance of hepatically metabolized drugs. In this study, we investigated the duration and additional anesthetic requirement during Magnetic resonance imaging (MRI) in epileptic children with or without phenobarbital monotherapy. ⋯ We suggest that the variability in response to the initial sedative agents during MRI requires titration of additive sedation with ketamine in epileptic children on phenobarbital monotherapy.
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Paediatric anaesthesia · Oct 2011
Randomized Controlled TrialThe perioperative dialogue reduces postoperative stress in children undergoing day surgery as confirmed by salivary cortisol.
To evaluate the efficacy of 'the perioperative dialogue (PD)' by analyzing salivary cortisol, in 5- to 11-year-old children undergoing day surgery. ⋯ The PD's caring, continuity, and on-going dialogues were associated with low concentrations of salivary cortisol postoperatively and reduced morphine consumption and thus appears to be a valuable complement to standard perioperative care in children undergoing day surgery.
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Paediatric anaesthesia · Oct 2011
Postoperative adverse respiratory events in preschool patients with inhaled foreign bodies: an analysis of 505 cases.
To identify the risk factors associated with postoperative adverse respiratory events in preschool-aged children with inhaled foreign bodies (FBs) undergoing rigid bronchoscopy. ⋯ Preoperative respiratory impairment may develop the patients with FBs into postoperative adverse respiratory events.
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Paediatric anaesthesia · Oct 2011
Postoperative hyponatremia following calvarial vault remodeling in craniosynostosis.
The incidence, severity, and risk factors for the development of hyponatremia in patients undergoing craniosynostosis surgery are not well known. ⋯ The incidence of postoperative hyponatremia after calvarial vault remodeling was determined to be 30.6%. Hyponatremia was significantly associated with increased pre-operative ICP, blood loss, and female gender (normal pre-operative ICP). The average decrease in sodium was greater in patients receiving hyponatremic postoperative IVF's.
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Paediatric anaesthesia · Oct 2011
Perioperative management of children undergoing craniofacial reconstruction surgery: a practice survey.
To assess current practices in the management of children undergoing craniofacial surgery and identify areas of significant practice variability with the intent to direct future research. ⋯ Significant variability exists in the management of children undergoing these procedures; further study is required to determine the optimal management strategies. Clinical trials assessing the utility of central venous pressure and other hemodynamic monitoring modalities would enable evidence-based decision-making for monitoring in these children. The development of institutional transfusion thresholds should be encouraged, as there exists a body of evidence supporting their efficacy and safety.