Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2013
Impact of sevoflurane anesthesia on cerebral blood flow in children younger than 2 years.
To assess the impact of sevoflurane and anesthesia-induced hypotension on cerebral blood flow (CBF) in children younger than 2 years. ⋯ Our results are in favor of a reduction in CBF after induction with sevoflurane in children younger than 6 months. This population is more sensitive to MAP decrease than older children because of a lower limit of cerebral autoregulation, and this limit may be 38 mmHg with sevoflurane anesthesia.
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Paediatric anaesthesia · Oct 2013
Educational outcome in adolescence following pyloric stenosis repair before 3 months of age: a nationwide cohort study.
Immature animals exposed to anesthetics display apoptotic neurodegeneration with subsequent long-term cognitive dysfunctions. Young age at anesthetic exposure is believed to be critical, but human studies are scarce. This study investigated the association between exposure to surgery and anesthesia for pyloric stenosis (PS) before 3 months of age and subsequent educational outcome in adolescence. ⋯ Children operated for PS before 3 months of age have educational performance tests similar to the background population at age 15-16 years after adjusting for known confounders. The higher nonattainment rate could suggest that a subgroup of PS children is developmentally disadvantaged.
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Paediatric anaesthesia · Oct 2013
Autonomic cardio-respiratory reflex reactions and superselective ophthalmic arterial chemotherapy for retinoblastoma.
To describe our experience with superselective ophthalmic artery chemotherapy (SOAC) in retinoblastoma and to report the serious adverse cardio-respiratory reactions we have observed. ⋯ Adverse cardio-respiratory reactions are commonly observed in SOAC for retinoblastoma. We believe that the adverse clinical signs represent an autonomic reflex response, akin to the trigemino-cardiac or oculo-respiratory reflexes, and all patients should be considered at-risk. Reactions occur only during second or subsequent procedures and can be life-threatening. The routine use of intravenous atropine does not seem to have altered the incidence or severity of these reactions. Anesthetists and interventional neuroradiologists involved in SOAC must be vigilant to ensure adverse reactions, when they develop, are treated quickly and effectively.
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Paediatric anaesthesia · Oct 2013
Case ReportsContinuous postoperative analgesia via quadratus lumborum block - an alternative to transversus abdominis plane block.
Different transversus abdominis plane blocks techniques cause variations in postoperative analgesia characteristics. We report the use of unilateral quadratus lumborum catheter for analgesia following colostomy closure. ⋯ No complications were reported in this pediatric patient. More studies are needed to evaluate the effectiveness and safety of this regional anesthesia technique.
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Paediatric anaesthesia · Oct 2013
Comparative StudyIntravenous versus intramuscular epinephrine administration during cardiopulmonary resuscitation - a pilot study in piglets.
Early epinephrine administration in cardiac arrest seems to be advantageous to achieve return of spontaneous circulation (ROSC). Because intravenous (i.v.) or intraosseous access is not always immediately available, this study compares efficacy of early intramuscular (i.m.) epinephrine administration with early and delayed i.v. epinephrine injection in an animal cardiac arrest model. ⋯ Early i.m. epinephrine provided similar survival compared with early i.v. epinephrine and was superior to delayed epinephrine administration in resuscitation of ropivacaine-induced cardiac arrest in piglets.