Paediatric anaesthesia
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Coaxial tomography (CT) and magnetic resonance imaging (MRI) scans are so much part of neurological investigation these days and provide such detailed information that even thorough neurological clinical examination may be neglected. The investigations in common use forty years ago were pneumoencephalography, ventriculography in babies with hydrocephalus, and carotid angiography with the injection of X-ray contrast to outline the arteries.
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Paediatric anaesthesia · Aug 2012
Randomized Controlled TrialProspective model-based comparison of different laryngoscopes for difficult intubation in infants.
Difficult intubation in infants is uncommon but may be a challenge for the anesthesiologist. Many optical-assisted techniques are available to ease endotracheal placement of tube but have not been systemically evaluated for pediatric practice. ⋯ Inexperienced anesthetists have higher success rates and shorter intubation times with optical-assisted laryngoscopes compared with conventional Macintosh laryngoscope. Gyrus Infant Bullard(®) laryngoscope significantly undertakes best success rate and shortest intubation time with mildest impact to maxillary dents and easiest technique. Our findings support the hypothesis that optical laryngoscopes can be used successfully by inexperienced anesthetists in simulated difficult pediatric airway conditions.
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Paediatric anaesthesia · Aug 2012
Randomized Controlled TrialClinical sedation and bispectral index in burn children receiving gamma-hydroxybutyrate.
Gamma-hydroxybutyrate (GHB) may be an interesting hypnotic agent in burn patients because of its good respiratory or hemodynamic tolerance. However, its clinical and electroencephalographic (EEG) sedative effects are not yet described in children. The aim of this prospective and randomized study was to assess clinical and EEG effects of increasing intravenous (IV) doses of GHB in burn children requiring sedation for burn wound cares. ⋯ Bispectral index decreased after GHB injection and was correlated with OAAS score. Deep sedation can be safely achieved with IV doses of 25 or 50 mg · kg(-1), but the last dose was associated with prolonged duration of clinical sedation.
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Paediatric anaesthesia · Aug 2012
Anesthesia for Treacher Collins syndrome: a review of airway management in 240 pediatric cases.
To review airway management with anesthesia for children with Treacher Collins syndrome (TCS) and determine whether intubation was more difficult with increasing age. ⋯ Most children with TCS have difficult laryngoscopic views with many requiring specialized intubation techniques. Direct laryngoscopy becomes more difficult with increasing age. The laryngeal mask airway is a good choice of airway when endotracheal intubation is not required.
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Paediatric anaesthesia · Aug 2012
Randomized Controlled TrialCardioprotective effect of transcutaneous electric acupoint stimulation in the pediatric cardiac patients: a randomized controlled clinical trial.
Acupuncture pretreatment exerts neuroprotective and cardioprotective effects in animal models and in adult patients underwent cardiac surgery; however, data in pediatric patient are unavailable. ⋯ Transcutaneous electric acupoint stimulation on the bilateral P6 acupoint is effective for attenuation myocardial injury in children undergoing cardiac surgery. The beneficial effects may be partially associated with reduction in cTnI and C-reactive protein level in the early postoperative period.