Paediatric anaesthesia
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Paediatric anaesthesia · May 2014
Cost-effectiveness of intravenous acetaminophen for pediatric tonsillectomy.
The primary outcome of this study was to examine the cost-effectiveness of the intraoperative combination of intravenous (IV) acetaminophen and IV opioids, versus IV opioids alone, as a part of an inhalational anesthetic technique for tonsillectomy in children. ⋯ The routine use of IV acetaminophen as an adjuvant to IV opioids for tonsillectomy with or without adenoidectomy in children aged <17 years should be considered as a means to reduce the need for rescue analgesia and in turn reduce costs.
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Paediatric anaesthesia · May 2014
Comparative Study Observational StudyAccuracy of manual palpation vs ultrasound for identifying the L3 -L4 intervertebral space level in children.
Insertion of needles into the spinal or epidural space is an important component of modern anesthetic practice. Needles are usually inserted at or below the L3-L4 intervertebral space to minimize the risk of spinal cord injury. Manual palpation is the most common method for identifying intervertebral spaces. However, anesthesiologists are increasingly using ultrasonography to guide the placement of regional, including neuraxial, anesthetic, and analgesic blocks. We undertook an observational study to compare the accuracy of manual palpation and ultrasound for determining the L3-L4 intervertebral space level. ⋯ This observational study found no difference in the accuracy of landmark palpation, when performed by a consultant anesthesiologist, and ultrasound for determining the L3-L4 intervertebral space in children.
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Paediatric anaesthesia · May 2014
Dose requirements of remifentanil for intubation in nonparalyzed Chinese children.
The objective of this study was to determine ED50 and ED95 of remifentanil for intubation combined with propofol in nonparalyzed Chinese children. ⋯ When used in combination with 2.5 mg·kg(-1) of intravenous propofol, ED50 and ED95 of remifentanil for adequate intubation in nonparalyzed children were lower than previously reported, at 2.30 and 2.75 μg·kg(-1), respectively.
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Paediatric anaesthesia · May 2014
Case ReportsSuccessful use of C-Mac video laryngoscope in a child with large parapharyngeal mass.
An eleven-year-old child presented with a history of gradually increasing left side neck swelling and snoring for the last 6 years. He was initially scheduled for biopsy and on a second occasion for transcervical excision of left parapharyngeal mass under general anesthesia. Examination showed a left lateral pharyngeal and tonsillar mass compressing the oropharyngeal airway. ⋯ After repeated attempts, intubation was possible with direct laryngoscopic-guided oral FOB. Fifteen days later, for the definitive surgery, the glottis was visualized at the first attempt using a C-Mac video laryngoscope and endotracheal intubation was successful at the first attempt after laryngeal manipulation. We discuss the potential causes of failure of intubation with the other airway devices in this child.
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Paediatric anaesthesia · May 2014
Perioperative complications in patients diagnosed with mucopolysaccharidosis and the impact of enzyme replacement therapy followed by hematopoietic stem cell transplantation at early age.
Mucopolysaccharidoses (MPS) are hereditary storage diseases; airway management typically worsens in these patients with the progression of the disease. ⋯ Perioperative airway management was most successful using a laryngeal mask airway or video laryngoscope. Treatment with ERT followed by HSCT and patient age did not influence the incidence of perioperative respiratory problems.