Paediatric anaesthesia
-
Paediatric anaesthesia · Oct 2020
Randomized Controlled TrialEffects of intraoperative dexmedetomidine on the incidence of acute kidney injuryin pediatric cardiac surgery patients: A randomized controlled trial.
Perioperative dexmedetomidine use has been reported to reduce the incidence of postoperative acute kidney injury after adult cardiac surgery. However, large-scale randomized controlled trials evaluating the effect of dexmedetomidine use on acute kidney injury in pediatric patients are lacking. ⋯ Intraoperative dexmedetomidine did not reduce acute kidney injury incidence in pediatric cardiac surgery patients.
-
Paediatric anaesthesia · Oct 2020
Case ReportsBradycardia and asystole during temporomandibular joint reconstruction.
Anesthesia providers are familiar with the oculocardiac reflex, one type of trigeminocardiac reflex. While less common, arrhythmias associated with manipulation of other trigeminal nerve branches can occur. We report the presentation and management of bradycardia and asystole from stimulation of the mandibular branch of the trigeminal nerve during temporomandibular joint reconstruction.
-
Paediatric anaesthesia · Oct 2020
Femoral Nerve Catheters Are Associated with Limb Strength Asymmetry at 6 Months After Primary Anterior Cruciate Ligament Reconstruction in Pediatric Patients.
The postoperative implications of single-injection femoral nerve blockade and femoral nerve catheter placement for anterior cruciate ligament reconstruction are not well defined among pediatric patients. Femoral nerve blockade may be associated with deficits in quadriceps symmetry at 6 months postoperative. ⋯ Though time to return to sport did not differ, patients in the femoral nerve catheter group exhibited greater single-leg squat asymmetry than did those in the femoral nerve blockade group approximately 6 months postoperatively. Persistent functional deficits may be important to consider when treating pediatric patients undergoing anterior cruciate ligament reconstruction.
-
Paediatric anaesthesia · Oct 2020
Observational StudyThe predictive value of the Pleth Variability Index on fluid responsiveness in spontaneously breathing anaesthetized children - a prospective observational study.
In children, the preoperative hydration status is an important part of the overall clinical assessment. The assumed preoperative fluid deficit is often routinely replaced during induction without knowing the child's actual fluid status. ⋯ The Pleth Variability Index may be of additional value to predict fluid responsiveness in spontaneously breathing anesthetized children. A significant overlap in baseline Pleth Variability Index values between fluid responsive and nonfluid responsive patients does not allow a reliable recommendation as to a cut off value.
-
Paediatric anaesthesia · Oct 2020
Comparison of regional analgesia techniques for pleurodesis pain in pediatric patients.
Mechanical pleurodesis can prevent recurrence of spontaneous pneumothorax but is associated with significant postoperative pain. Adequate pain control is not only beneficial for patient comfort but also critical for mobilization and pulmonary recovery. Thoracic epidural catheters and paravertebral blocks have been used to alleviate pain after thoracoscopic surgery. However, no studies have evaluated the safety and efficacy of paravertebral block vs epidural analgesia vs no block in children undergoing pleurodesis. ⋯ Thoracic epidural analgesia offers a reduction in opioid use in the first two post-op days after pleurodesis but did not produce a clinically significant reduction in pain scores in comparison with paravertebral block or no block.