Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2018
Observational StudyProspective analysis of serious cardiorespiratory events in children during ophthalmic artery chemotherapy for retinoblastoma under a deep standardized anesthesia.
Serious adverse cardiorespiratory events complicate super selective ophthalmic artery chemotherapy for retinoblastoma in anesthetized children. Their mechanism remains unclear but may be attributed to an autonomic nervous reflex induced by the catheter close to the ophthalmic artery. Inadequate depth of anesthesia during catheter stimulation might be an aggravating factor. Thus, we tested whether deep general anesthesia reduced the incidence of serious cardiorespiratory events. ⋯ Serious cardiorespiratory events occur commonly during super selective ophthalmic artery chemotherapy. Standardized deep anesthesia with analgesia did not appear to be protective. No predictive factors were identified, but these events systematically arose within 2 minutes after ophthalmic artery catheter insertion. Anesthetists and neuroradiologists should be prepared to manage these serious complications and parents should be informed of the risks.
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'The association of hypotension with the insertion of an abdominal retractor during lower abdominal surgery in pediatric patients: a retrospective observational study' by Rika Nakayama, Takahiro Mihara, Yoshihisa Miyamoto & Koui Ka.1 The above article from Pediatric Anesthesia, published online on July 7, 2015 in Wiley Online Library (http://wileyonlinelibrary.com) has been retracted by agreement between the authors, the Journal Editor in Chief, Andrew Davidson, and John Wiley & Sons Ltd. The retraction has been agreed following a review of the study data by the authors, which found that cases not satisfying the inclusion criteria were included and that there were data collection errors with respect to the patients' ages and sexes. As a result, the authors judged that the reproducibility of the results could not be guaranteed and have requested retraction. ⋯ Nakayama R, Mihara T, Miyamoto Y, Ka K. The association of hypotension with the insertion of an abdominal retractor during lower abdominal surgery in pediatric patients: a retrospective observational study. Pediatr Anesth. 2015;25:824-828. https://doi.org/10.1111/pan.12656.
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Paediatric anaesthesia · Feb 2018
Randomized Controlled TrialOn-line preparatory information for children and their families undergoing dental extractions under general anesthesia: A phase III randomized controlled trial.
Family-centered interactive on-line games are increasingly popular in healthcare, but their effectiveness for preoperative preparation needs further research. www.scottga.org is the new on-line version of a proven nonweb-based game for children and parents/caregivers. ⋯ Families believed that a video-game preparation helped their child's perioperative anxiety, but there were no objective measures of behavioral improvement associated with this intervention.
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Paediatric anaesthesia · Feb 2018
Extubation in the operating room after pediatric liver transplant: A retrospective cohort study.
Early extubation immediately following liver transplantation is increasingly common in adult practice. Some pediatric institutions have begun to adopt this strategy. Careful patient selection is essential in minimizing risk. ⋯ More than half of our pediatric liver transplant patients were successfully extubated in the operating room immediately following surgery. We believe early extubation to be safe when employed in selected subpopulations of pediatric patients undergoing liver transplantation.
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Paediatric anaesthesia · Feb 2018
Optimum time for intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide in children without any premedication.
Intravenous cannulation is usually done in children after inhalational induction with volatile anesthetic agents. The optimum time for safe intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide has been studied in premedicated children, but there is no information for the optimum time for cannulation with inhalational induction in children without premedication. ⋯ We recommend waiting for 1 minute 45 seconds (105 seconds) after the loss of eyelash reflex before attempting intravenous cannulation in pediatric patients induced with sevoflurane, oxygen, and nitrous oxide without any premedication.