Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2014
Randomized Controlled Trial Comparative StudyIntranasal dexmedetomidine vs midazolam for premedication in children undergoing complete dental rehabilitation: a double-blinded randomized controlled trial.
This prospective, randomized, double-blind study was designed to evaluate the use of intranasally administered dexmedetomidine vs intranasal midazolam as a premedication in children undergoing complete dental rehabilitation. ⋯ Intranasal dexmedetomidine (1 μg·kg(-1)) is an effective and safe alternative for premedication in children; it resulted in superior sedation in comparison to 0.2 mg·kg(-1) intranasal midazolam. However, it has relatively prolonged onset of action.
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Paediatric anaesthesia · Feb 2014
Randomized Controlled TrialRandomized controlled trial of daily interruption of sedatives in critically ill children.
To study the feasibility of daily interruption of sedatives in critically ill children. ⋯ Daily interruption of sedatives in critically ill children is feasible, results in decreased use of sedation, earlier extubation, and shorter length of stay.
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Paediatric anaesthesia · Feb 2014
Randomized Controlled TrialAprotinin and transfusion requirements in pediatric craniofacial surgery.
To evaluate transfusion requirements in children receiving aprotinin during craniofacial surgery. ⋯ Aprotinin was associated with decreased packed red blood cell transfusion requirements in children undergoing craniofacial surgery, with no renal toxicity or death. Aprotinin is no longer available for clinical use in the USA because of adverse effects in adults; re-evaluation of aprotinin is warranted for children scheduled to undergo surgery involving potentially high blood loss.
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Paediatric anaesthesia · Feb 2014
Randomized Controlled Trial Comparative StudyChildren's cognitive recovery after day-case general anesthesia: a randomized trial of propofol or isoflurane for dental procedures.
Postoperative cognitive dysfunction (POCD) is well established in adults but has been underinvestigated in children. As day-case procedures are increasingly common, it is important to establish whether children suffer significant POCD. Pediatric POCD has been associated with several intravenous and inhalation anesthetics, but isoflurane has not been studied. As evidence indicates superior recovery after propofol, the study compared POCD after propofol or isoflurane anesthesia. ⋯ Propofol and isoflurane exert similar adverse effects on RT, psychomotor coordination, and visual memory. Selective impairment of verbal recall by propofol is consistent with adult evidence of the drug's effect on retrieval. The enduring postoperative impairment of memory has implications for instructions to parents and caregivers for the safety and well-being of children in the 24 h after day-case anesthesia with propofol and isoflurane.