Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2012
Randomized Controlled Trial Comparative StudyThe Size 1 ProSeal™ laryngeal mask airway in infants: a randomized, noncrossover study with the Classic™ laryngeal mask airway.
In recent years, numerous scientific publications have endorsed the superiority of the ProSeal™ laryngeal mask airway (PLMA) over the Classic™ laryngeal mask airway (cLMA) in adults, children, and infants. The PLMA forms a better seal for both the respiratory and gastrointestinal tracts, provides easier access to the gastrointestinal tract, and exerts lower mucosal pressures for a given seal pressure. This study aims to determine whether this superiority can also be observed for the size 1 PLMA used in anesthetized neonates and infants with positive pressure ventilation. ⋯ We conclude that the size 1 PLMA is a stable, safe, and efficacious airway control device during neonatal and infant anesthesia, allowing higher peak airway pressure during positive pressure ventilation, with fewer mask displacements and gastric insufflations than the cLMA.
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Paediatric anaesthesia · Apr 2012
Randomized Controlled Trial Comparative StudyComparison of size 2 i-gel supraglottic airway with LMA-ProSeal™ and LMA-Classic™ in spontaneously breathing children undergoing elective surgery.
We compared size 2 i-gel(®) (Intersurgical Inc.), a relatively new supraglottic airway device for use in spontaneously breathing anesthesized children with two different types of laryngeal mask airway-ProSeal™ laryngeal mask airway (PLMA) and Classic™ laryngeal mask airway (cLMA) for the ease of insertion, oropharyngeal sealing pressures (OSPs), and air leak. The hemodynamic effects on insertion of device and postoperative adverse effects were also noted. ⋯ Pediatric size 2 i-gel is easy to insert and provides higher OSP compared with same size PLMA and cLMA in spontaneously breathing children undergoing elective surgery. It may be a safe alternative to laryngeal mask airways in day care surgeries.
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Paediatric anaesthesia · Apr 2012
Randomized Controlled TrialPressure support ventilation vs spontaneous ventilation via ProSeal™ laryngeal mask airway in pediatric patients undergoing ambulatory surgery: a randomized controlled trial.
To investigate the advantages of using pressure support ventilation (PSV) vs spontaneous ventilation via ProSeal™ laryngeal mask airway in children undergoing ambulatory surgery. ⋯ Pressure support ventilation via ProSeal™ laryngeal mask airway during general anesthesia improves ventilation in pediatric patients undergoing ambulatory surgery. However, this did not translate to a difference in clinical outcome among our study patients.
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Paediatric anaesthesia · Apr 2012
Case ReportsAwake GlideScope intubation in a critically ill pediatric patient.
We report a challenging case of a 10-year-old boy with history of biventricular heart failure, pulmonary hypertension, severe asthma, and obesity with a BMI of 37. He presented to our hospital in acute decompensated heart failure. Our anesthesia team was consulted by the pediatric intensivist for urgent airway management in this rapidly deteriorating, premorbid patient. We describe here the use of the GlideScope(®) in an awake pediatric patient of ASA 4E status with a potentially difficult airway who required to remain in the seated position and thus necessitating a face-to-face approach.
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Paediatric anaesthesia · Apr 2012
Minimum alveolar concentration of desflurane with fentanyl for laryngeal mask airway removal in anesthetized children.
Desflurane provides rapid emergence from anesthesia. So, it can be used for the removal of a laryngeal mask airway in an anesthetized child. We conducted this study to determine the optimal endtidal concentrations of desflurane with fentanyl that would allow removal of a laryngeal mask airway without airway complication in children. ⋯ Removal of laryngeal mask airway can be safely accomplished without coughing, moving, or any other airway complications at 3.57% endtidal concentrations of desflurane with fentanyl in 50% of anesthetized children.