Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2016
Case ReportsFailed fiberoptic intubation in a child with epidermolysis bullosa, rescued with combined use of the Glidescope(®).
We present the case of a 13-year-old male with epidermolysis bullosa having an elective syndactyly release. These patients present significant challenges to the anaesthetist; extreme care in patient handling is required. Recurrent and pronounced scarring of intra-oral, pharyngeal and laryngeal tissues is a feature, resulting in a difficult airway. ⋯ This proved immediately successful. Its utilisation has been reported in adults. We wish to present our experience in the paediatric population, and this is the first report in a child with epidermiolysis bullosa.
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Paediatric anaesthesia · Apr 2016
Feasibility, efficacy, and safety of ultrasound-guided axillary plexus blockade in pediatric patients with epidermolysis bullosa dystrophica.
In patients suffering from epidermolysis bullosa dystrophica (DEB), the most severe form of epidermolysis bullosa, trauma or friction cause separation of the skin from underlying tissue with consecutive painful blisters, scarifications, contractures, and pseudosyndactyly. To retain functionality of the hands surgical procedures are necessary. Anesthesia is challenging as difficult airways make general anesthesia risky. Regional anesthesia is considered controversial in patients with EB as accidental subcutaneous injections can cause severe blisters. As ultrasound-guided procedures became standard of care this might have changed however. ⋯ Ultrasound-guided plexus axillaris block in DEB patients undergoing hand surgery in our institution has been feasible, effective, and safe.
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Paediatric anaesthesia · Apr 2016
Erythropoietin diminishes isoflurane-induced apoptosis in rat frontal cortex.
During the brain growth spurt, anesthetic drugs can cause cellular and behavioral changes in the developing brain. The aim of this study was to determine the neuroprotective effect of erythropoietin after isoflurane anesthesia in rat pups. ⋯ A total of 1000 IU·kg(-1) IP erythropoietin diminished isoflurane-induced neuroapoptosis. Further experimental studies have to be planned to reveal the optimal dose and timing of erythropoietin before adaptation to clinical practice.