Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2013
Observational StudyThe SNAP index does not correlate with the State Behavioral Scale in intubated and sedated children.
Ensuring appropriate levels of sedation for critically ill children is integral to pediatric critical care. Traditionally, clinicians have used subjective scoring tools to assess sedation levels. The SNAP II uses dual frequency processed electroencephalography to evaluate brain activity and may provide an objective assessment of sedation levels. ⋯ The SNAP index does not correlate with SBS scores in our pediatric intensive care unit (PICU). Its use cannot be recommended to measure levels of sedation in our population. Future research should continue to explore objective ways of measuring sedation in critically ill children.
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Paediatric anaesthesia · Dec 2013
Randomized Controlled TrialPostoperative emergence delirium in pediatric patients undergoing cataract surgery - a comparison of desflurane and sevoflurane.
Desflurane and sevoflurane are associated with postoperative emergence delirium (ED) in children. The study aimed to compare the use of desflurane and sevoflurane to determine the postoperative ED in children undergoing cataract surgery using the validated Pediatric Anesthesia Emergence Delirium (PAED) scale. ⋯ Emergence delirium (ED) after desflurane and sevoflurane anesthesia was comparable using a validated PAED scale in pediatric cataract surgery. There was no correlation between preoperative anxiety and ED in these children; however, children with higher pain scores were more likely to have a higher ED.
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Paediatric anaesthesia · Dec 2013
Multicenter Study Comparative StudyAccuracy of acoustic respiration rate monitoring in pediatric patients.
Rainbow acoustic monitoring (RRa) utilizes acoustic technology to continuously and noninvasively determine respiratory rate from an adhesive sensor located on the neck. ⋯ When compared to nasal capnography, RRa showed good agreement and similar accuracy and precision but was better tolerated in postsurgical pediatric patients.
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Paediatric anaesthesia · Dec 2013
Randomized Controlled Trial Comparative StudyComparison of heart rate variability response in children undergoing elective endotracheal intubation with and without neuromuscular blockade: a randomized controlled trial.
The routine use of neuromuscular blocking drugs (NMBD) for endotracheal intubation in children is the subject of much controversy. The analysis of heart rate variability (HRV) can reveal information about the functional state of the autonomic nervous system (ANS). ⋯ The stress response during endotracheal intubation in pediatric patients represented by the frequency domain analysis of HRV was found to be higher without NMB. When mivacurium was added to a propofol-fentanyl induction regimen, the ANS alterations during endotracheal intubation decreased significantly.
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Paediatric anaesthesia · Dec 2013
Comparative StudyWashout times of desflurane, sevoflurane and isoflurane from the GE healthcare Aisys(®) and Avance(®) Carestation(®) and Aestiva(®) Anesthesia System.
Malignant hyperthermia susceptible patients may experience a fatal reaction to volatile anesthetic gases. This study sought to determine the washout characteristics of desflurane, sevoflurane, and isoflurane from the Aisys® , Avance® , and Aestiva® anesthesia machines. (GE Healthcare, Madison, WI, USA). ⋯ This study demonstrates that saturated vapor pressure and priming concentration exert a greater effect on washout times than gas solubility. The Aisys utilizes an electronic vaporizer system that may expose the breathing system to retained saturated vapor. The breathing systems for all machines may hinder washout of gases.