Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2019
Randomized Controlled TrialManual versus pressure-controlled facemask ventilation during the induction of general anaesthesia in children: a prospective randomised controlled study.
Pressure-controlled face mask ventilation during paediatric induction reduces gastric insufflation compared with manual ventilation.
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Paediatric anaesthesia · Apr 2019
Randomized Controlled TrialComparison of low-fresh gas flow technique to standard technique of sevoflurane induction in children-A randomized controlled trial.
Although sevoflurane is preferred for inhalational induction in children, financial and environmental costs remain major limitations. The aim of this study was to determine if the use of low-fresh gas flow during inhalational induction with sevoflurane could significantly reduce agent consumption, without adversely affecting induction conditions. ⋯ Induction of anesthesia with sevoflurane using low-fresh gas flow is effective in reducing sevoflurane consumption, without compromising induction time and conditions.
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Paediatric anaesthesia · Apr 2019
Observational StudyThe angle range of leg abduction with external hip rotation which can minimize femoral artery and vein overlap in pediatric patients.
Since the femoral artery frequently overlaps the femoral vein, femoral central venous catheterization carries the risk of arterial puncture in pediatric patients. ⋯ Positioning patients in a range of 48° and 58° leg abduction with external hip rotation can minimize the overlap between the femoral artery and vein. However, the clinical usefulness of this positioning for femoral venous catheterization remains to be seen.
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Paediatric anaesthesia · Apr 2019
Observational StudySaving sevoflurane: Automated gas control can reduce consumption of anesthetic vapor by one-third in pediatric anesthesia.
Many modern anesthetic machines offer automated control of anesthetic vapor. The user simply sets a desired end-tidal concentration and the machine will manipulate the vaporizer and gas flow rates to obtain and maintain the preset target. Greater efficiency, and more accurate delivery of anesthetic vapor have been documented across multiple machines within the adult setting however, there is little evidence for their use in children. ⋯ Maquet's Flow-i automatic gas control mode reduced use of sevoflurane an average of one-third in a pediatric anesthesia setting.
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Paediatric anaesthesia · Apr 2019
Observational StudyThe impact of a quality improvement project to standardize pain, agitation, and withdrawal assessments on the use of morphine and midazolam in the Pediatric Intensive Care Unit.
This study aims to assess the impact of a quality improvement initiative to increase assessments of pain, agitation, and iatrogenic withdrawal syndrome, on the use of sedative and analgesic medication in a pediatric intensive care unit. ⋯ Implementation of a multifaceted QI project was successful at increasing standardized assessments of pain and agitation, and was associated with a significant reduction in midazolam use. We also observed a decrease in morphine use without increasing rates of severe pain. Incidence of iatrogenic withdrawal syndrome and cost were unchanged.