Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2017
ReviewChloroprocaine for epidural anesthesia in infants and children.
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long-term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics. ⋯ The current manuscript reviews the literature pertaining to the use of 2-chloroprocaine for regional anesthesia in infants and children. Dosing regimens are presented and the applications of 2-chloroprocaine in this population are discussed.
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Paediatric anaesthesia · Jun 2017
Randomized Controlled Trial Comparative StudyComparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination.
Pediatric ophthalmic examinations can be conducted under sedation either by chloral hydrate or by dexmedetomidine. The objective was to compare the success rates and quality of ophthalmic examination of children sedated by intranasal dexmedetomidine vs oral chloral hydrate. ⋯ Intranasal dexmedetomidine provides more successful sedation and better quality of ophthalmic examinations than oral chloral hydrate for small children.
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Paediatric anaesthesia · Jun 2017
Tracheal extubation practices following adenotonsillectomy in children: effects on operating room efficiency between two institutions.
Adenotonsillectomy is one of the most commonly performed operative procedures in children. It is imperative to find the most efficient and cost-effective methods of practice to facilitate operating room management while maintaining patient safety. We investigated the efficiency of two different approaches of tracheal extubation in pediatric patients following adenotonsillectomy at two tertiary care pediatric hospitals with large surgical volumes. The primary aim of the study was to determine the difference in the operating room time according to the institutional practice of tracheal extubation in the postanesthesia care unit (PACU) as compared to the operating room. ⋯ Tracheal extubation in the PACU is an efficient use of operating room time and resources.
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Paediatric anaesthesia · Jun 2017
Metatropic dysplasia-a skeletal dysplasia with challenging airway and other anesthetic concerns.
Metatropic dysplasia is a rare form of skeletal dysplasia requiring multiple anesthetics for surgical and imaging procedures, most of which are orthopedic procedures. We provide centralized care to patients with skeletal dysplasia at our tertiary care pediatric hospital, and we were able to collect the largest number of metatropic dysplasia patients reported to date. ⋯ Difficult airway is the most common co-morbid condition present in patients with metatropic dysplasia, especially if their cervical spine has been fused. Familiarity with the difficulties involving the airway and its management is critical in safe and successful management of anesthesia in this high-risk population.