Paediatric anaesthesia
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Paediatric anaesthesia · May 2015
Randomized Controlled TrialDose effect of local anesthetics on analgesic outcomes for the transversus abdominis plane (TAP) block in children: a randomized, double-blinded, clinical trial.
Current knowledge on local anesthetic dosage for the TAP block in pediatric patients is very limited. ⋯ The use of higher local anesthetic doses for the TAP block in children does not provide benefits on early pain scores but seems to improve analgesic duration and decrease the need for additional analgesics over 24 h after surgery. The use of higher, but yet safe, local anesthetic dosages for TAP blocks is a viable strategy to improve analgesia in children.
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Paediatric anaesthesia · May 2015
Dexmedetomidine-ketamine combination and caudal block for superficial lower abdominal and genital surgery in children.
The use of dexmedetomidine-ketamine combination to perform different diagnostic and surgical pediatric procedures has increased. The optimal ketamine dose to combine with dexmedetomidine has not been determined. The goal of this study was to determine the ED50 and ED95 of ketamine, which in combination with, dexmedetomidine (1 μg · kg(-1)) provides an adequate anesthetic effect to perform a caudal block and then the ensuing superficial lower abdominal or genital surgery. ⋯ These results suggest that adding ketamine 2 mg · kg(-1) to dexmedetomidine 1 μg · kg(-1) should produce an effective anesthetic level to perform a caudal block and the ensuing superficial lower abdominal or genital surgery in children.
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Paediatric anaesthesia · May 2015
Review Case ReportsVolatile anesthetics for status asthmaticus in pediatric patients: a comprehensive review and case series.
Status asthmaticus is an acute, intractable asthma attack refractory to standard interventions that can lead to progressive respiratory failure. Successful management requires a fundamental understanding of the disease process, its clinical presentation, and proper evaluation. Treatment must be instituted early and is aimed at reversing the airway inflammation, bronchoconstriction, and hyper-reactivity that often lead to lower airway obstruction, impaired ventilation, and oxygenation. ⋯ In addition, we include a proven approach to the management of these patients in the critical care setting, which requires close coordination between critical care and anesthesia providers. We present a case series of three patients, two of which have the longest reported cases of continuous isoflurane use in status asthmaticus. This series was obtained from a retrospective chart review and highlights the efficacy of the volatile anesthetic, isoflurane, in three pediatric patients with refractory life-threatening status asthmaticus.
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Paediatric anaesthesia · May 2015
Historical ArticleThe development of pediatric anesthesia and intensive care in Scandinavia.
The initiation and development of pediatric anesthesia and intensive care have much in common in the Scandinavian countries. The five countries had to initiate close relations and cooperation in all medical disciplines. The pediatric anesthesia subspecialty took its first steps after the Second World War. ⋯ Although pediatric anesthesia/intensive care is not a separate specialty, an 'informal accreditation' for a specialist position is obtained after training. The pleasure of working in a relatively small group of devoted colleagues and staff has persisted from the pioneering years. It is still one of the most inspiring and pleasant gifts for those working in this demanding specialty.