Paediatric anaesthesia
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Paediatric anaesthesia · May 2021
Food Allergy History and Reaction to Propofol Administration in a Large Pediatric Population.
Anaphylaxis to propofol is rare; however, providers face a clinical quandary as medication warnings still exist regarding propofol administration to egg-, soy-, and peanut-allergic patients. ⋯ In the listed food-allergic cohort, the majority had no allergy testing or negative testing. We found no evidence of a relationship between food allergy history and perioperative propofol reaction. We suggest multiply allergic and atopic patients may have a similar likelihood of propofol reaction as with other medications.
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Paediatric anaesthesia · May 2021
Case ReportsAn unexpected Covid-19 diagnosis during emergency surgery in a neonate.
A 4-day-old, 3.3 kg infant presented with suspected intestinal malrotation, necessitating emergent diagnostic laparoscopy. Intra-operatively, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) came back positive. This is the first case report of emergency surgery and anesthesia in a positive SARS-CoV-2 newborn. This report highlights a neonate with an incidental positive SARS-CoV-2 test, no known exposure history, negative polymerase chain reaction maternal testing, and absence of respiratory symptoms who required modified pressure control ventilation settings to adequately ventilate with the high-efficiency particulate air filter in situ.
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Paediatric anaesthesia · May 2021
ReviewPerianesthetic neurological adverse events in children: A review of the Wake-Up Safe Database.
Perianesthetic neurological adverse events are rare in children and have been studied in detail in the settings of cardiac surgery and regional anesthesia. Our study aims to characterize perianesthetic neurological adverse events in children in the setting of all types of surgery and diagnostic or interventional procedures, to evaluate anesthesia's role, and to identify factors amenable to prevention. ⋯ Perianesthetic neurological adverse events are rare in children and have a poor outcome. Our study has described pediatric perianesthetic neurological injury in detail and identified contributing factors that can be optimized during various phases of perianesthetic care. This information can be utilized during the informed consent process and to enhance the quality of care in children receiving anesthesia.
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Paediatric anaesthesia · May 2021
Tracheal Intubation related adverse Events in Pediatrics Anesthesia in Ethiopia.
Tracheal intubation is a common intervention for many pediatric surgical patients. Even though it can be lifesaving, it carries a risk of morbidity and even mortality. Evidence is lacking regarding the adverse events related to pediatric intubation in Ethiopia. This study is aimed to assess the scale of tracheal intubation-related adverse events with its associated factors in pediatrics surgical patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. ⋯ The incidence of tracheal intubation-related adverse events in pediatric surgical patients is high. Anesthesia professionals should be vigilant and have a preplanned strategy to avoid intubation-related adverse events, especially in high-risk patients. The use of difficult airway algorithms, oxygen saturation monitoring, and training in simulation room are very important strategies to help reduce patient harm.
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Paediatric anaesthesia · May 2021
The Impact of Surgical Cancellations on Children, Families, and the Health System in an Australian Paediatric Tertiary Referral Hospital.
Reasons for elective surgery cancelations and their impact vary from one institution to another. Cancelations have emotional and financial implications for patients and their families. Our service has a particularly broad and geographically diverse patient population; hence, we sought to examine these impacts in our service. ⋯ During our study period, a total of 7870 procedures were booked. 6734 (86%) of these were completed and 1136 (14%) were canceled, with 6% canceled on the day of surgery. In 750 (66%) of these cancelations, families were successfully contacted by telephone and agreed to participate. Of these 305 (41%) cancelations were family-initiated and 444 (59%) were hospital-initiated, with these hospital-initiated cancelations occurring closer to scheduled surgery. The most common cause of cancelation was that the child could not undergo the procedure due to illness (22%) or being unable attend the hospital (14%). The greatest disruption to families and children occurred when procedures were canceled late, particularly when the cancelation occurred on the day of the planned procedure.