Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2018
Case ReportsVirtual reality for lumbar puncture in a morbidly obese patient with leukemia.
Virtual reality is an immersive technology that can provide distraction and anxiolysis during painful procedures. While it has been shown to be effective in less invasive procedures, it is underutilized in more invasive procedures. We describe using virtual reality for a morbidly obese patient with leukemia undergoing lumbar puncture. The use of virtual reality reduced the amount of analgesics and anxiolytics and the procedure and recovery times compared with no virtual reality.
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Satisfaction in the hospital setting is an important component of both hospital funding and patient experience. When it comes to a child's hospital experience, parent satisfaction of their child's perioperative care is also necessary to understand. However, little research has been conducted on the predictors of this outcome. Therefore, the purpose of this current study was to validate a priori selected predictors for parental satisfaction in their child's perioperative process. ⋯ Lower parent anxiety and higher child social functioning were predictive of higher parental satisfaction scores.
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Paediatric anaesthesia · Nov 2018
Randomized Controlled TrialA randomized controlled trial of oral chloral hydrate vs intranasal dexmedetomidine plus buccal midazolam for auditory brainstem response testing in children.
Moderate to deep sedation is required for an auditory brainstem response test when high-intensity stimulation is used. Chloral hydrate is the most commonly used sedative, whereas intranasal dexmedetomidine is increasingly used in pediatric non-painful procedural sedations. ⋯ Intranasal dexmedetomidine plus buccal midazolam was associated with higher sedation success with deeper level of sedation, with similar discharge time and adverse event rate when compared to chloral hydrate.
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Paediatric anaesthesia · Nov 2018
ReviewDiagnosis and perioperative management in pediatric sleep-disordered breathing.
Sleep-disordered breathing has a prevalence of 12% in the pediatric population. It represents a spectrum of disorders encompassing abnormalities of the upper airway that lead to sleep disruption, including primary snoring, obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation. Sleep-disordered breathing is the most common indication for adenotonsillectomy, one of the most common procedures performed in children. ⋯ This article presents an overview of the recent literature on the perioperative care of pediatric patients with sleep-disordered breathing. It highlights innovative modalities and limitations in diagnosing obstructive sleep apnea, the importance of a tailored anesthetic/analgesic approach to children with obstructive sleep apnea, and the need for postoperative monitoring. It also brings to focus that further studies on the perioperative care of these children are necessary.
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Paediatric anaesthesia · Nov 2018
Biography Historical ArticleHalf a century of anesthesia for children: An interview with Dr. Nishan G. 'Nick' Goudsouzian.
The career of Dr Nishan Goudsouzian spanned half a century of pediatric anesthesia. His 50 years saw seminal contributions to the use of neuromuscular blocking agents in children, the development of proton beam therapy and magnetic resonance imaging for pediatric cancer, the introduction of the laryngeal mask airway, an explosion in the volume and depth of knowledge about pediatric anesthesia, the expansion of formal training in pediatric anesthesia, and the widening of academic efforts to improve anesthetic care for children worldwide. Based on interviews with Dr Goudsouzian, this article reviews the contributions of this Robert M. Smith Award winner to the development of pediatric anesthesia.