Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2013
Review Meta AnalysisEfficacy and safety of intraoperative dexmedetomidine for acute postoperative pain in children: a meta-analysis of randomized controlled trials.
Aim of the current meta-analysis was to assess the effects of intraoperative dexmedetomidine on postoperative pain, analgesic consumption, and adverse events in comparison with placebo or opioids in children undergoing surgery. ⋯ This meta-analysis revealed a lower risk for postoperative pain and the need for postoperative opioids following intraoperative dexmedetomidine in comparison with placebo or opioids in children undergoing surgery; however, the influence of dexmedetomidine on postoperative opioid consumption is less clear. Although there were only a limited number of adverse events, further studies focusing on procedure specific dexmedetomidine dosing and adverse events are urgently needed.
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Paediatric anaesthesia · Feb 2013
Randomized Controlled Trial Comparative StudyA randomized equivalence trial comparing the i-gel and laryngeal mask airway Supreme in children.
The laryngeal mask airway Supreme (Supreme) is a new single-use supraglottic device with gastric access capability now available in all sizes for children. ⋯ In infants and children, when a single-use supraglottic device with gastric access capabilities is required, the i-gel demonstrated higher airway leak pressures and can be a useful alternative to the Supreme.
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Paediatric anaesthesia · Feb 2013
Randomized Controlled TrialA psychological preoperative program: effects on anxiety and cooperative behaviors.
To evaluate the effectiveness of a psychological preoperative program in reducing preoperative anxiety and in promoting compliance of pediatric participants with surgical procedures. ⋯ Preparing children through playful dramatization of the operative procedure, manipulation of medical instruments and psychologist's support may be useful in pediatric surgery structures.
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Paediatric anaesthesia · Feb 2013
Oxidative stress markers are not associated with outcomes after pediatric heart surgery.
To investigate whether perioperative serum levels of oxidative stress markers, thiobarbituric acid reactive substances (TBARS), and carbonyl moieties are associated with outcomes in children after heart surgery. ⋯ In conclusion, oxidative stress markers TBARS and carbonyl moieties were not associated with the development of LCOS, the aLOS, or mortality in children after heart surgery with CPB.
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Paediatric anaesthesia · Feb 2013
Case ReportsMeningococcemia and heparin-induced thrombocytopenia: a dangerous combination.
We present a dramatic case of a patient presenting with disseminated intravascular coagulation related to meningococcal sepsis who developed heparin-induced thrombocytopenia following heparin administration during continuous renal replacement therapy. Association of these two prothrombotic conditions led to severe limbs ischemia and finally to bilateral legs amputation. We stress the importance of suspect heparin-induced thrombocytopenia in intensive care unit patients, especially when an improvement of other coagulation parameters is observed, and heparin therapy was started.