Paediatric anaesthesia
-
Paediatric anaesthesia · Aug 2018
Randomized Controlled TrialDorsal penile nerve block for circumcision in pediatric patients: A prospective, observer-blinded, randomized controlled clinical trial for the comparison of ultrasound-guided vs landmark technique.
Circumcision is a frequently performed procedure in day case pediatric surgery. Dorsal penile nerve block has proven its effectiveness for the management of acute postoperative pain after circumcision. We investigated if the ultrasound-guided placement of a dorsal penile nerve block could reduce opioid requirement as compared to a landmark-based technique. ⋯ Compared with the landmark-guided, the ultrasound-guided dorsal penile nerve block did not reduce the need for postoperative analgesia after circumcision in children, but was associated with an increase in the procedural time.
-
Paediatric anaesthesia · Aug 2018
Randomized Controlled TrialThe effect of xenon-augmented sevoflurane anesthesia on intraoperative hemodynamics and early postoperative neurocognitive function in children undergoing cardiac catheterization: A randomized controlled pilot trial.
In adults, xenon has only minimal hemodynamic side effects when compared with other anesthetics. Moreover, in preclinical experiments, xenon has been demonstrated to possess cardio- and neuroprotective properties. Altogether, the favorable hemodynamic profile combined with its potential for organ-protection could render xenon an attractive option for anesthesia in children with cardiovascular compromise. ⋯ In this pilot trial, xenon-augmented sevoflurane anesthesia in school-aged children was feasible, and associated with decreased ephedrine requirements. All children exposed to anesthesia showed impaired neurocognitive performance in the immediate postoperative period when compared to control children; however, without significant differences between both treatment groups.
-
Paediatric anaesthesia · Aug 2018
Randomized Controlled TrialEffects of remifentanil maintenance during recovery on emergence delirium in children with sevoflurane anesthesia.
Emergence delirium is a common complication of sevoflurane anesthesia in children. ⋯ Maintaining a low dose of remifentanil (0.05 μg/kg/min) throughout the recovery phase attenuated the incidence of emergence delirium in children undergoing strabismus surgery under sevoflurane anesthesia.
-
Paediatric anaesthesia · Aug 2018
Review Historical ArticleThe Ayre's T-piece turns 80: A 21st century review.
Ayre's T-piece, first introduced 80 years ago, continues to be widely used in pediatric anesthesia despite colossal advances in equipment and technology. We present a review of its history, advantages, and disadvantages, and place in modern-day clinical practice.
-
Paediatric anaesthesia · Aug 2018
Infraorbital foramen location in the pediatric population: A guide for infraorbital nerve block.
Infraorbital nerve blocks are often performed for the management of postoperative pain associated with cleft lip correction. Infraorbital nerve block procedures depend on the identification of the infraorbital foramen; however, there is little information regarding the infraorbital foramen location in the pediatric population. ⋯ The infraorbital foramen was located within 2 mm, on average, from the nasospinale-to-jugale midpoint regardless of age group. Therefore, the nasospinale-to-jugale midpoint may serve as useful means of identifying the location of the infraorbital foramen in the pediatric population and aid in optimizing infraorbital nerve block procedures. The information in this report is valuable in general, but may be particularly useful in developing countries where there is a lack of ultrasound training and availability for health care providers; or places where infraorbital nerve block may be the sole anesthetic modality for cleft lip surgery, even among adolescent patients.