Paediatric anaesthesia
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Paediatric anaesthesia · May 2020
Review Meta AnalysisThe effectiveness of PC6 acupuncture in the prevention of postoperative nausea and vomiting in children- A systematic review and meta-analysis.
A growing number of studies have demonstrated the effectiveness of acupuncture in preventing and treating postoperative nausea and vomiting. Here, we used meta-analysis to confirm these benefits in children and to determine the optimal time to perform this treatment. ⋯ Acupuncture reduces the incidence of postoperative nausea and vomiting as well as the utilization of antiemetic remedies, particularly during the first 4 hours following the operation. Acupuncture performed before anesthesia was demonstrated to be the most ideal intervention time for children.
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Paediatric anaesthesia · May 2020
Randomized Controlled TrialUltrasonographic evaluation of gastric emptying after ingesting carbohydrate-rich drink in young children: A randomized crossover study.
A recent consensus statement in Europe has suggested that the fasting time for clear liquid in children can be shortened to 1 hour before a surgery. However, the study to show that 1-hour fasting time for clear fluids is safe in young children is still lacking. This study aimed to investigate the gastric emptying time for carbohydrate-rich drink and regular 5% glucose solution in children aged 3-7 years. ⋯ Gastric emptying of carbohydrate-rich drink is slower than that of 5% glucose solution but the residual gastric fluid volume is low one hour after ingestion of 5 mL kg-1 of either fluid.
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Paediatric anaesthesia · May 2020
Randomized Controlled TrialPharmacokinetics of an intravenous bolus dose of clonidine in children undergoing surgery.
Clonidine is used off-label in children but only limited pediatric pharmacokinetic data are available for intravenously administered clonidine. ⋯ Pharmacokinetic parameter estimates were similar for children undergoing general surgery and cardiac surgery given a single dose of intravenous clonidine. These results indicated that no dose reduction is needed in children aged 1 to <2 years compared with those 2-5 years, which was supported by pharmacodynamic observations.
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Paediatric anaesthesia · May 2020
ReviewPediatric Obstructive Sleep Apnea: Preoperative and Neurocognitive Considerations for Perioperative Management.
Obstructive sleep apnea (OSA) affects up to 7.5% of the pediatric population and is associated with a variety of behavioral and neurocognitive sequelae. Prompt diagnosis and treatment is critical to halting and potentially reversing these changes. ⋯ However, it carries its own perioperative risks and the decision regarding surgical timing is therefore made in the context of procedural risk versus patient benefit. This article presents the seminal perioperative and neurocognitive risks from pediatric OSA to aid with perioperative management.
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Paediatric anaesthesia · May 2020
ReviewTransgender Pediatric Surgical Patients - Important Perioperative Considerations.
Transgender describes a variety of identities in which an individual's gender identity is different from expected based on the sex assigned at birth. In the United States, it is estimated that over 1 million adults and 150 000 youth identify as transgender, with increasing numbers being seen in healthcare and surgical settings. ⋯ However, this is not the only circumstance in which the pediatric anesthesiologist may find themselves caring for a transgender patient. In order to provide the safest and most affirming care, it is crucial that the pediatric anesthesiologist develop a working knowledge of this unique and vulnerable population, including the potential impacts of gender-affirming treatment on their perioperative care.