Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2016
Review Meta AnalysisOutcomes of dexmedetomidine treatment in pediatric patients undergoing congenital heart disease surgery: a meta-analysis.
Dexmedetomidine decreases cardiac complications in adults undergoing cardiovascular surgery. This systematic review assessed whether perioperative dexmedetomidine improves congenital heart disease (CHD) surgery outcomes in children. ⋯ Current evidence indicates that dexmedetomidine improves outcomes in children undergoing CHD surgery. However, this finding largely relies on data from observational studies; high-quality RCTs are warranted because of the potential for subject selection bias.
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Paediatric anaesthesia · Mar 2016
Randomized Controlled Trial Comparative StudyComparison of rescue techniques for failed chloral hydrate sedation for magnetic resonance imaging scans-additional chloral hydrate vs intranasal dexmedetomidine.
Chloral hydrate, a commonly used sedative in children during noninvasive diagnostic procedures, is associated with side effects like prolonged sedation, paradoxical excitement, delirium, and unpleasant taste. Dexmedetomidine, a highly selective α-2 agonist, has better pharmacokinetic properties than chloral hydrate. We conducted this prospective, double-blind, randomized controlled trial to evaluate efficacy of intranasal dexmedetomidine with that of a second oral dose of chloral hydrate for rescue sedation during magnetic resonance imaging (MRI) studies in infants. ⋯ Intranasal dexmedetomidine induced satisfactory rescue sedation in 1- to 6-month-old infants during MRI study, and appears to cause sedation in a dose-dependent manner.
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Paediatric anaesthesia · Mar 2016
Postoperative pain control with paravertebral catheters after pediatric total pancreatectomy and islet autotransplantation: a retrospective cohort study.
Total pancreatectomy and islet autotransplantation (TPIAT) has been used to treat pediatric patients with chronic pancreatitis. The primary symptom of this disease is extreme poorly controlled pain. This results in significant alterations in the quality of life of the patient. We sought to determine if the addition of bilateral thoracic paravertebral catheters with continuous ropivacaine infusion would improve postoperative opioid use and pain control. ⋯ Bilateral paravertebral catheters may provide decreased opioid use and improved postoperative pain control after TPIAT.
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Paediatric anaesthesia · Mar 2016
Usefulness of stroke volume variation to assess blood volume during blood removal for autologous blood transfusion in pediatric patients.
Dynamic variables based on the heart-lung interaction induced by positive pressure ventilation have not been shown to be useful in assessing cardiac preload in pediatric patients. ⋯ Stroke volume variation obtained from the FloTrac/Vigileo(TM) monitoring system revealed a strong correlation with EBV during ANH without surgical stimulation. The usefulness of this device as an indicator of cardiac preload under hypovolemic or normovolemic conditions in children during surgery remains to be determined.