Paediatric anaesthesia
-
Paediatric anaesthesia · May 2013
Randomized Controlled Trial Comparative StudyA randomized comparison of caudal block by sacral hiatus injection under ultrasound guidance with traditional sacral canal injection in children.
There is a risk of inadvertent dural or vascular puncture for the traditional single-shot caudal block performed by inserting the needle into the sacral canal through the sacral hiatus. This prospective, randomized study was to evaluate the clinical feasibility of the hiatus injection under ultrasound guidance for caudal block in children. ⋯ Sacral hiatus injection offers a reliable caudal block for pediatric inguinal hernia repair with the advantages of easier performance and fewer complications compared with traditional sacral canal injection.
-
Paediatric anaesthesia · May 2013
Randomized Controlled TrialRandomized trial of success of pediatric anesthesiologists learning to use two video laryngoscopes.
The primary purpose of this study was to establish the ability of pediatric anesthesiologists to learn to use two video laryngoscopes - the GlideScope(®) system (GS) and the Karl Storz Direct Coupled Interface, DCI(®), (KS). ⋯ Although only 65% of anesthesiologists attained the stringent study definition of 'Success', all rapidly leaned to use both video laryngoscopes.
-
Paediatric anaesthesia · May 2013
Comparative StudyA new endotracheal tube for infants--laboratory and clinical assessment: a preliminary study.
Conventional endotracheal pediatric tubes offer high resistance due to their small diameters and relatively high flow during ventilation. Any increase of the diameter of the tube lumen decreases the airway resistance and subsequently, the work of breathing (WOB). We compared ventilation mechanics using a new, cone-shaped endotracheal tube of our design to the Cole and standard tubes. ⋯ The cone tube offers lower resistance to gas flow than the standard, used nowadays in clinical practice. It can be especially beneficial to spontaneously breathing patients reducing WOB and improving gas exchange.
-
Paediatric anaesthesia · May 2013
Procedural pain in neonates: the state of the art in the implementation of national guidelines in Italy.
National and international guidelines have been published on pain control and prevention in the newborn, but data on compliance with these guidelines are lacking. ⋯ This survey showed that most Italian NICUs provide some form of analgesia and sedation for invasive procedures in accordance with national guidelines, but their routine adherence to best practices for pain control and monitoring is still suboptimal.
-
Paediatric anaesthesia · May 2013
Case ReportsPneumoperitoneum for neonatal laparoscopy: how safe is it?
We present the case of a 3 day old term neonate who experienced a cardiopulmonary arrest during creation of pneumoperitoneum for laparoscopic repair of duodenal atresia. The arrest was thought likely to have occurred as a result of a gas embolism. We discuss the features of the neonatal circulation which may predispose neonates to embolic phenomena during laparoscopic procedures, and the potential benefit of priming the insufflation apparatus with carbon dioxide. The possibility of gas embolism should be considered when contemplating laparoscopic surgery in this patient group.