Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2022
Case ReportsAnesthetic Management in an Infant with Tetra-amelia Syndrome with Congenital Maxillomandibular Fusion: A Case Report.
A 10-month-old girl who had tetra-amelia syndrome and congenital maxillomandibular fusion (syngnathia) was scheduled for the surgical fusion separation. Anesthetic management for this case was considerably challenging. ⋯ Connecting anesthetic circuit with nasopharyngeal airway was the preferred technique due to its benefits such as maintaining spontaneous ventilation, providing inhaled anesthetic, as well as monitoring oxygenation and ventilation. Importantly, the cornerstones for handling such complicated cases are multidisciplinary approach and teamwork.
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Paediatric anaesthesia · Aug 2022
Remote After-Care Using Smartphones (RACUS): a feasibility study of monitoring children's pain with automated SMS messaging.
Monitoring children's recovery postoperatively is important for routine care, research, and quality improvement. Although telephone follow-up is common, it is also time-consuming and intrusive for families. Using SMS messaging to communicate with families regarding their child's recovery has the potential to address these concerns. While a previous survey at our institution indicated that parents were willing to communicate with the hospital by SMS, data on response rates for SMS-based postoperative data collection is limited, particularly in pediatric populations. ⋯ This methodology is likely to generalize well to other simple clinical questions and produce good response rates in further similar studies. We expect SMS messaging to permit expanded longitudinal data collection and broader investigation into patient recovery than previously feasible using telephone follow-up at our institution.
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Paediatric anaesthesia · Aug 2022
Dexmedetomidine as a sole sedative for procedural sedation in preterm and neonate infants: a retrospective analysis.
Many different sedation concepts for magnetic resonance imaging have been described for prematurely and term-born infants, ranging from "no sedation" to general anesthesia. Dexmedetomidine is an alpha-2 receptor agonist that is frequently used to sedate older children, because the anesthesiologist can easily adjust sedation depth, the patient maintains spontaneous breathing, and awakens rapidly afterwards. ⋯ These results indicate that dexmedetomidine can be safely used for procedural sedation in the high-risk cohort of prematurely and term-born infants less than 60 weeks postconceptional age. Apnea during procedural sedation and subsequent stay in the recovery room is avoided, but bradycardia remains a relevant risk that may require treatment.
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Paediatric anaesthesia · Aug 2022
The Association of Severe Pain Experienced in the PICU and Post-Discharge Health-Related Quality of Life: A Retrospective Cohort Study.
Pain may be a modifiable risk factor for lower health-related quality of life after pediatric critical illness. ⋯ Children who experience severe pain in the pediatric intensive care unit have lower postdischarge health-related quality of life adjusting for baseline health-related quality of life, particularly among children who have undergone surgery. Attention to pain management may be important to improve postdischarge health-related quality of life.