Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2018
Observational StudyAutonomic cardiac regulation after general anesthesia in children.
General anesthesia dramatically decreases the activity of the autonomic nervous system. Most of the hypnotic agents used to induce anesthesia inhibit sympathetic cardiovascular regulation and baroreflex control in a dose-dependent manner, lowering cardiac adaptability during the operation. The consequence of this effect in children during and after surgery has never been studied to date. ⋯ Autonomic nervous function normalizes rapidly (within 12 hours) in prepubertal children. This study indicates that general anesthesia does not seem to increase the long-term risk of autonomic dysfunction in these patients.
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Paediatric anaesthesia · Oct 2018
Determining the extent of the dural sac for the performance of caudal epidural blocks in newborns.
Information regarding the position and relationship of vital structures within the caudal canal is important for anesthesiologists who perform a caudal block. This information can be acquired by anatomical dissection, with ultrasound technology, or radiological studies. ⋯ Anesthesiologists should be aware of the short distance between the sacral hiatus and the dural sac when performing caudal blocks, the shortest distance was 4.94 mm. Armed with this knowledge, caudal techniques should be modified to improve the safety and reduce the risk of complications, such as dural puncture.
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Paediatric anaesthesia · Oct 2018
Observational StudyUltrasound assessment of the prevalence of increased gastric contents and volume in elective pediatric patients: A prospective cohort study.
Though pulmonary aspiration of gastric contents occurs mainly in the setting of emergency surgery, it may also occur in children scheduled for elective surgery without any obvious clinical risk factor. Increased gastric content volume is one the predisposing factors for pulmonary aspiration that could affect such children and may be identified using ultrasound examination of the gastric antrum. ⋯ According to our results, only 1% of elective children had potentially increased risk for pulmonary aspiration. Further studies should be performed in order to define the target population of elective children for which ultrasound assessment of gastric content should be performed prior to general anesthesia.