Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2012
Randomized Controlled TrialEmergency airway access in children--transtracheal cannulas and tracheotomy assessed in a porcine model.
In the rare scenario when it is impossible to oxygenate or intubate a child, no evidence exists on what strategy to follow. ⋯ In a piglet model, we found no significant difference in success rates or time to insert a jet ventilation cannula or an intravenous catheter transtracheally, but the incidence of complications was high. In the same model, we found a 97% success rate for performing an emergency tracheotomy within 4 min with a low rate of complications.
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Paediatric anaesthesia · Dec 2012
Comparative StudyThe difficult airway trolley in pediatric anesthesia: an international survey of experience and training.
The pediatric difficult airway can be unexpected, leading to significant morbidity and mortality. Standardized emergency airway equipment should be available on a regularly checked difficult airway trolley (DAT). We conducted a survey to investigate pediatric anesthetists' knowledge, experience, and confidence with the DAT. ⋯ Training and recent use of the DAT increases anesthetists' confidence, but is not a universal practice. A significant number of anesthetists reported problems with the DAT, raising issues of equipment maintenance and quality control.
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Paediatric anaesthesia · Dec 2012
Randomized Controlled TrialPerioperative outcomes of severely obese children undergoing tonsillectomy.
Severe obesity (BMI > 98th centile) in paediatric tonsillectomy is associated with an increased risk of perioperative respiratory complications.
pearl -
Paediatric anaesthesia · Dec 2012
Randomized Controlled TrialAsleep-awake-asleep technique in children during strabismus surgery under sufentanil balanced anesthesia.
Both over- and undercorrection can occur in up to 10-15% of strabismus surgeries. Use of adjustable suture technique and an intraoperative awake test may decrease the incidence of over- or undercorrection. In this study, we investigated the ability to provide optimal conditions for intraoperative awake strabismus suture adjustment in children by means of target-controlled infusions (TCI) of propofol and remifentanil propofol compared with propofol and sufentanil. ⋯ Propofol combined with sufentanil or remifentanil can be suitable for planned intraoperative awakening for an adjustable suture technique in pediatric patients during strabismus surgery. Remifentanil has quicker wake-up time; however, sufentanil demonstrated an advantage in terms of better analgesia, more stable hemodynamics, and improved qualify of awakening.
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Intussusception is the most frequent cause of bowel obstruction in children. Although enema is usually used as the initial treatment, surgery may be required in more than 50% of patients. General anesthesia (GA) has been suggested to increase the rate of enema success. The purpose of this study was to evaluate whether GA increases the success rate of reduction by air enema. ⋯ Air enema performed under GA allows intussusception reduction in more than 90% of patients.