Paediatric anaesthesia
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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.
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Paediatric anaesthesia · Oct 2018
Modeling the pharmacokinetics and pharmacodynamics of sevoflurane using compartment models in children and adults.
Sevoflurane pharmacokinetics have been traditionally described using physiological models, while pharmacodynamics employed the use of minimal alveolar concentration. ⋯ Pharmacokinetic compartment models offer an alternative method to describe inhalation anesthetic drug disposition and effects.