Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2022
Case ReportsA Case Report: Anesthetic Management for Open-Heart Surgery in a Child with Congenital Insensitivity to Pain with Anhidrosis.
Congenital insensitivity to pain with anhidrosis (CIPA) is a rare disease also known as hereditary sensory and autonomic neuropathy. CIPA is characterized by a lack of pain sensitivity and impaired development of sweat glands. Surgery is required for patients with self-mutilation and skeletal developmental disorders. ⋯ Although there have been a few cases of CIPA patients receiving surgery and anesthesia, the number is very limited. Here, we report a case of a child with CIPA who underwent open-heart surgery and discuss the anesthetic considerations. We conclude that patients with CIPA undergoing open-heart surgery require some opioids, that muscle relaxants and volatile anesthetics should be used with extreme caution, and that airway management and temperature control require special attention.
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Paediatric anaesthesia · Sep 2022
Review Meta AnalysisVideolaryngoscopes versus direct laryngoscopes in children: ranking systematic review with network meta-analyses of randomized clinical trials.
Videolaryngoscopes improve tracheal intubation in adult patients, but we currently do not know whether they are similarly beneficial for children. We designed this ranking systematic review to compare individual video and direct laryngoscopes for efficacy and safety of orotracheal intubation in children. ⋯ Videolaryngoscopes reduce the risk of failed first intubation attempts and major complications in children compared to direct laryngoscopes. However, not all videolaryngoscopes have the same performance metrics, and more data is needed to clarify which device may be better in different clinical scenarios. Additionally, care must be taken while interpreting our results and rankings due to the available evidence's low or very low quality.
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Paediatric anaesthesia · Sep 2022
Carotid Doppler ultrasonography as a method to predict fluid responsiveness in mechanically ventilated children.
The aim of this study was to investigate whether respiratory variations in carotid and aortic blood flows measured by Doppler ultrasonography could accurately predict fluid responsiveness in critically ill children. ⋯ Analysis of respiratory changes in carotid and aortic blood flows are accurate methods for predicting fluid responsiveness in children under invasive mechanical ventilation.
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Paediatric anaesthesia · Sep 2022
Observational StudyTarget insertion depth of nasopharyngeal temperature probes in children: A prospective observational study analyzing magnetic resonance images.
Core temperature monitoring is indispensable to prevent children from perioperative thermal perturbations. Although nasopharyngeal measurements are commonly used in anesthesia and considered to reflect core temperature accurately, standardized target depths for probe insertion are unknown in children. ⋯ Height-based formulas could be a valuable proxy for the insertion depth of nasopharyngeal temperature probes. Further clinical trials are necessary to investigate their measurement accuracy.
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Paediatric anaesthesia · Sep 2022
Effect of a carbohydrate lollipop on the gastric volume of fasted pediatric patients.
Preoperative fasting is part of routine practice. Children subjected to prolonged preoperative fasting often suffer adverse effects. Consuming a preoperative lollipop may lessen their anxiety and have clinical benefits. ⋯ Consuming a standard lollipop did not affect the gastric volume of fasted pediatric patients.