Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2022
Randomized Controlled TrialSingle bolus dexmedetomidine versus propofol for treatment of pediatric emergence delirium following general anesthesia.
Pediatric emergence delirium is a psychomotor disorder occurring in the early postanesthetic stage. There is no clear consensus regarding its treatment; however, dexmedetomidine and propofol have both been shown to be effective. ⋯ A single bolus of 0.5 μg.kg-1 of dexmedetomidine was more effective than a single bolus of 1 mg.kg-1 of propofol in treating emergence delirium during the early postanesthetic stage.
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Paediatric anaesthesia · Mar 2022
Observational StudyValidation of a new combined transcutaneous tcPCO2 and tcPO2 sensor in children in the operating theater.
Arterial blood gas analysis is the gold standard for monitoring of Pa CO2 and PaO2 during mechanical ventilation. However, continuous measurements would be preferred. Transcutaneous sensors continuously measure blood gases diffusing from the locally heated skin. These sensors have been validated in children mostly in intensive care settings. Accuracy in children during general anesthesia is largely unknown. ⋯ This study showed good agreement between Pa CO2 and tcPCO2 in children of all ages during general anesthesia. Both transcutaneous and endtidal CO2 measurements showed good accuracy. TcPO2 is only accurate under 6 months of age.
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Paediatric anaesthesia · Mar 2022
A novel approach to operating room readiness for airborne precautions using simulation-based clinical systems testing.
The emergence of the COVID-19 disease as a global pandemic caused major challenges and strained busy operating room environments. This required institutions to rethink current system functioning and urgently develop safe medical practices and protocols. ⋯ This study demonstrated a flexible methodology that effectively integrated simulation-based training and systems tests to train staff and detect latent safety threats in the new workflows and provide recommendations for mitigation. While COVID was the specific prompt, this approach can be applicable in diverse clinical settings for training medical staff, testing system function, and mitigating potential latent safety threats.
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Paediatric anaesthesia · Mar 2022
Case ReportsLocal anesthetic toxicity following erector spinae plane block in a neonate: A case report.
A 6-day-old, 4.0 kg neonate presented with intestinal malrotation, necessitating laparotomy. Intra-operatively, an ultrasound-guided erector spinae plane block was performed under general anesthesia with administration of 1 mg/kg levobupivacaine. ⋯ Intralipid (1.5 ml/kg) was given, with a return to normal hemodynamic parameters. This is the first case report of suspected local anesthetic toxicity in a neonate following an erector spinae plane block.
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Paediatric anaesthesia · Mar 2022
Clinical significance of assessing cerebral blood volume by time-domain near-infrared spectroscopy in children with congenital heart disease.
Despite providing cerebral tissue oxygen saturation (StO2 ), the lack of quantitative information for continuous wave near-infrared spectroscopy (CW-NIRS) is an obstacle in evaluating cerebral hemodynamic conditions. Time-domain NIRS (TD-NIRS) provides both StO2 and cerebral blood volume and has recently become clinically available. ⋯ Cerebral blood volume monitoring detected differences in cerebral hemodynamic conditions, related to the age and the type of ventricle physiologies. However, the differences were not apparent in StO2 . The additional monitoring of cerebral blood volume by TD-NIRS would facilitate a better understanding of cerebral hemodynamic conditions in patients with congenital heart disease.