Paediatric anaesthesia
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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.
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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
Laryngeal view and temperature measurements while using the perilaryngeal airway (Cobra-PLUS™) in children.
The Cobra-PLUS™ perilaryngeal airway (CP) is a modification of the Cobra perilaryngeal airway. It has a distal curve for easier placement and a thermistor on the pharyngeal cuff. We assessed the orientation of the larynx to the CP and compared temperatures measured using CP to temporal arterial (TA) and infrared tympanic (T) thermometers. ⋯ The CP has a better orientation to the larynx compared with its previous version. It may be used to reliably trend intraoperative temperatures.
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Paediatric anaesthesia · Dec 2013
Skin temperature over the carotid artery provides an accurate noninvasive estimation of core temperature in infants and young children during general anesthesia.
The accurate measurement of core temperature is an essential aspect of intraoperative management in children. Invasive measurement sites are accurate but carry some health risks and cannot be used in certain patients. An accurate form of noninvasive thermometry is therefore needed. Our aim was to develop, and subsequently validate, separate models for estimating core temperature using different skin temperatures with an individualized correction factor. ⋯ Skin temperature over the carotid artery, with a simple correction factor of +0.52°C, provides a viable noninvasive estimate of Tnaso in young children during elective surgery with a general anesthetic.