Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2011
ReviewAnesthetic management of congenital tracheoesophageal fistula.
This article reviews (a) risk factors and preoperative considerations of the patient with tracheoesophageal fistula, (b) anesthetic management, including (i) airway management, (ii) induction of anesthesia and monitoring and (iii) postoperative disposition, (c) considerations for concomitant congenital heart disease, (d) considerations for thoracoscopic repair and (e) long-term outcomes and considerations of the patient with repaired esophageal atresia/tracheoesophageal fistula.
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Paediatric anaesthesia · Nov 2011
ReviewNasal foreign bodies in children: considerations for the anesthesiologist.
The combination of a curious young child exploring his/her nasal cavities, with the abundance of small inert and natural objects in our society, culminates in a significant number of nasal foreign bodies (NFBs). Usually NFBs are benign entities, yielding relatively simple resolutions and mild morbidities. ⋯ This article discusses the different types of NFBs, various clinical presentations, diagnosis, pathophysiology, and pertinent considerations for the anesthesia care provider. Increasing one's awareness of the implications of NFBs, can optimize the safe treatment of patients harboring this development.
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Paediatric anaesthesia · Nov 2011
Clinical TrialUltrasound-guided subclavian vein cannulation in infants: supraclavicular approach.
Ultrasound (US) guidance techniques are reported to be safe for internal jugular vein catheterization, although anatomic conditions are not favorable for this approach in infants. The subclavian vein (SCV) seems to be a better site for long-term central venous catheterization in children, with a supraclavicular approach to avoid compression of the central venous catheter between the clavicle and the first rib ('pinch-off' syndrome). We describe a new US-guided approach for supraclavicular SCV cannulation in infants. ⋯ This US-guided supraclavicular approach for SCV puncture is a new possibility for central venous catheterization in small infants, offering all the advantages of SCV cannulation without the risk of 'pinch-off' syndrome. This technique seems valuable for children and infants and quite easy to apply for physicians trained to US guidance punctures.
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Paediatric anaesthesia · Nov 2011
Retrospective review of ilioinguinal-iliohypogastric nerve block with general anesthesia for herniotomy in ex-premature neonates.
We examine the efficacy and complications of general anesthesia with ilioinguinal-iliohypogastric nerve block performed on ex-premature neonates undergoing inguinal herniotomy. ⋯ Ilioinguinal-iliohypogastric nerve block has a success rate similar to other techniques and when combined with general anesthesia, provides a viable alternative technique of anesthesia in these high-risk patients.
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Digby Leigh was a pioneer of Canadian pediatric anesthesia. He was an outstanding man - once met, never forgotten. My only contact with him was at the First Paediatric Anaesthesia Workshop at HSC in Toronto organized by Alan Conn in 1964. ⋯ He moved to Montreal to attend McGill University because there was no medical school in Vancouver. He graduated in 1932 and, like many others, began surgical training at Montreal Children's before Wesley Bourne, Chief of Anaesthesia, persuaded him to change to Anaesthesia. He went to Madison, Wisconsin, and trained with one of the great pioneer teachers, Ralph Waters, for 3 years.