Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2019
Randomized Controlled Trial Clinical TrialUltrasound-guided erector spinae plane block for postoperative analgesia in pediatric patients undergoing splenectomy; a prospective randomized controlled trial.
Many analgesic modalities have been investigated in pediatrics. We studied the analgesic efficacy of bilateral ultrasound-guided erector spinae plane block in pediatric patients undergoing open midline splenectomy. ⋯ Ultrasound-guided erector spinae plane block reduced CHEOPS score for the first eight hours postoperatively with the reduction of intraoperative fentanyl and postoperative paracetamol consumptions.
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Paediatric anaesthesia · Dec 2019
Meta AnalysisThe Effect of Ketamine on Emergence Agitation in Children: A Systematic Review and Meta-analysis.
Although there is some evidence that ketamine may reduce emergence delirium in children, it is generally low quality and inconsistent, and practice change is not recommended.
pearl -
Paediatric anaesthesia · Dec 2019
Observational StudyA prospective observational cohort study on the incidence of postoperative sore throat in the paediatric population.
Postoperative sore throat is common after general anesthesia. The incidence in pediatric anesthesia is variable, and the etiology unclear. Establishing risk factors would enable prevention and could improve quality of care. ⋯ Postoperative sore throat is common in children. Endotracheal intubation is associated with a greater incidence than laryngeal mask airway use. A high rate of postoperative sore throat in children with endotracheal tube cuff pressures within the recommended range suggests multifactorial etiology. To confirm validity of the identified risk factors, we would recommend a larger prospective multi-center study.
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Paediatric anaesthesia · Dec 2019
Neonatal ICU Patients Recovering in the PACU: An Observational Analysis of Post-Extubation Complications.
Neonatal patients are at higher risk in the perioperative period than older infants and children. Extubation as an early goal for noenatal intensive care unit patients presenting for surgery is undergoing a renaissance period, and an exploration of adverse events following selection for extubation immediately after general anesthesia has not specifically been undertaken in this population. ⋯ The most important factors associated with major events in the post anesthesia care unit following extubation of neonatal intensive care unit patients were birth weight < 1.58 kg and postmenstrual age at surgery < 41 weeks. A patient with both features has a 7-fold increase in the odds of a major respiratory event in the post anesthesia care unit. Careful consideration of the postoperative ventilation and monitoring strategy must be given to patients with low birth weight (<1.58 kg) or who are <41 weeks postmenstrual age at the time of surgery.
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Paediatric anaesthesia · Dec 2019
Learning Curve of Ultrasound Measurement of Subglottic Diameter for Endotracheal Tube Selection in Pediatric Patients.
Endotracheal tube size can be predicted according to ultrasound measurement of subglottic airway diameter. The learning curve for this method is not yet established. The aim was to evaluate the learning curve of anesthesiology residents in ultrasound measurement of subglottic airway diameter for prediction of endotracheal tube size using cumulative sum analysis. ⋯ Learning curves constructed with cumulative sum analysis in this study showed that only 62.5% of residents were able to correctly predict cuffed endotracheal tube size with 80% success rate. Considerable variability in achieving competency necessitates objective follow-up of individual improvement.