Paediatric anaesthesia
-
Paediatric anaesthesia · Jun 2013
Multicenter StudyPediatric cardiopulmonary arrest in the postanesthesia care unit: analysis of data from the American Heart Association Get With The Guidelines-Resuscitation registry.
Nearly 20% of anesthesia-related pediatric cardiopulmonary arrests (CPAs) occur during emergence or recovery. The aims of this study were to describe (i) the nature of pediatric postanesthesia care unit (PACU) CPA and subsequent outcomes and (ii) factors associated with mortality. ⋯ This study identified similar risk factors and underlying causes as described in previous reports of pediatric perioperative CPA, with higher mortality following a cardiac/hemodynamic cause.
-
Paediatric anaesthesia · Jun 2013
Randomized Controlled TrialPhenylephrine as a simulated intravascular epidural test dose in pediatrics: a pilot study.
A test dose is used to detect intravascular injection during neuraxial block in pediatrics. Accidental intravascular epidural local anesthetic injection might be unrecognized in anesthetized children leading to potential life-threatening complications. In children, sevoflurane anesthesia blunts the hemodynamic response when intravascular cathecolamines are administered. No studies have explored the hemodynamics and the criteria for a positive test dose result following phenylephrine in sevoflurane anesthetized children. ⋯ Phenylephrine might be a future indicator of positive intravascular test dose. Further investigation is needed to find out the phenylephrine dose that elicits a reliable hemodynamic response and whether phenylephrine needs to be dose age-adjusted in order to appreciate relevant hemodynamic changes in children receiving neuraxial blocks undergoing general anesthesia.
-
Paediatric anaesthesia · Jun 2013
The STBUR questionnaire for predicting perioperative respiratory adverse events in children at risk for sleep-disordered breathing.
In the absence of formal polysomnography (PSG), many children with symptoms of sleep-disordered breathing (SDB) go unrecognized and thus may be at risk for perioperative respiratory adverse events (PRAE). ⋯ Children presenting for surgery with symptoms consistent with SDB may be at risk for PRAE. It is important therefore that anesthesia providers identify these individuals prior to surgery to avoid potential complications. The STBUR questionnaire appears promising as a simple, clinically useful tool for identifying children at risk for PRAE. Further studies to validate the STBUR questionnaire as a diagnostic tool may be warranted.
-
Paediatric anaesthesia · Jun 2013
Review Meta AnalysisOpioid-sparing effects of perioperative paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) in children.
Addition of paracetamol or NSAIDs significantly reduces post-operative opioid consumption in children, although not demonstrably opioid side effects.
pearl -
Paediatric anaesthesia · Jun 2013
Randomized Controlled Trial Comparative StudyComparison of topical tramadol and ketamine in pain treatment after tonsillectomy.
The primary objective of this study is to evaluate the effects of topically applied ketamine or tramadol on early postoperative pain scores in children undergoing tonsillectomy. The secondary aim of the study is to assess nausea, vomiting, difficulty in swallowing, and sore throat characteristics of the patients. ⋯ Topical tramadol and ketamine seem to be safe, effective, and easy analgesic approach for decreasing tonsillectomy pain.