Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2013
A retrospective study of multimodal analgesic treatment after laparoscopic appendectomy in children.
Laparoscopic appendectomy is a common emergency pediatric surgery procedure accompanied by substantial pain (pain scores >4 for >60% of the time) in 33% of these patients. We introduced a bundle of pain management interventions including local anesthetic infiltration at the incision site, intravenous (IV) opioids by patient-controlled analgesia (PCA), and scheduled doses of IV ketorolac and oral acetaminophen/hydrocodone. ⋯ The multimodal regimen of local anesthetic infiltration, opioid by PCA, NSAIDs, and oral acetaminophen/hydrocodone reduced the incidence of substantial pain. Additional studies are required to identify subgroups of patients with minimal opioid requirements who can benefit from modifications of this regimen.
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Paediatric anaesthesia · Dec 2013
Ultrasound-guided rectus sheath block for pyloromyotomy in infants: a retrospective analysis of a case series.
To analyze the applicability of US-guided rectus sheath block and to find out the efficacy of analgesia provided using this method without the need for opioids in conventional Hypertrophic pyloric stenosis (HPS) surgery in infants. ⋯ US-guided rectus sheath block seems to be a simple and quick method for the provision of intra- and postoperative analgesia in infants undergoing conventional HPS surgery.
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Paediatric anaesthesia · Dec 2013
Tobacco control education in pediatric anesthesiology fellowships.
Cigarette smoking and secondhand smoke exposure (SHS) increase the risk of perioperative complications. Traditionally, anesthesiologists have limited involvement in tobacco control. ⋯ Many pediatric anesthesiology fellowship directors agree that exposure to cigarette smoke adversely impacts patients in the perioperative period, but few participate in tobacco control, and issues germane to tobacco control are not consistently addressed.