Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2014
Variations in inpatient pediatric anesthesia in California from 2000 to 2009: a caseload and geographic analysis.
Regional referral systems are considered important for children hospitalized for surgery, but there is little information on existing systems. ⋯ Many urban California hospitals maintained low annual inpatient anesthetic caseloads for children ≤6 years while conducting potentially more complex procedures. Further efforts are necessary to define the scope of pediatric anesthetic care at urban low- and intermediate-volume hospitals in California.
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Paediatric anaesthesia · Dec 2014
Review Meta AnalysisAnalgesic effect and adverse events of dexmedetomidine as additive for pediatric caudal anesthesia: a meta-analysis.
Dexmedetomidine has become a popular additive for regional anesthesia. Aim of this meta-analysis was to assess the effect of this additive on the duration of postoperative analgesia and possible adverse events in pediatrics undergoing orchidopexy or lower abdominal surgery. ⋯ Dexmedetomidine as an additive to local anesthetic provides a significantly longer postoperative analgesia with comparable adverse effects and hemodynamic changes, when compared to local anesthetics alone. There were insufficient data of the effects of different concentrations of dexmedetomidine; further studies are required to explore this issue.
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Paediatric anaesthesia · Dec 2014
Randomized Controlled Trial Comparative StudyPositive-pressure ventilation during transport: a randomized crossover study of self-inflating and flow-inflating resuscitators in a simulation model.
Positive-pressure ventilation during transport of intubated patients is generally delivered via a hand-pressurized device. Of these devices, self-inflating resuscitators (SIR) and flow-inflating resuscitators (FIR) constitute the two major types used. Selection of a particular device for transport, however, remains largely an institutional practice. ⋯ Hand ventilation during patient transport is superior using the FIR compared to the SIR to achieve target ventilatory goals and avoid unacceptable ventilatory cycles.
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Paediatric anaesthesia · Dec 2014
Randomized Controlled TrialAnalgesic effects of gabapentin after scoliosis surgery in children: a randomized controlled trial.
Postoperative pain remains an important challenge after scoliosis surgery in children. Opioids are the mainstay of treatment, and adult studies demonstrate gabapentin as a useful adjunct to opioids in the management of postoperative pain. ⋯ A single preoperative dose of gabapentin did not show a significant difference in opioid consumption or pain scores in adolescents undergoing idiopathic scoliosis surgery. This study is the first pediatric randomized controlled trial to assess the effectiveness of a single dose of gabapentin on morphine consumption and analgesia following major surgery.