Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2023
Randomized Controlled TrialComparison of intravenous and inhalation anesthesia on postoperative behavior changes in children undergoing ambulatory endoscopic procedures: A randomized clinical trial.
Early and delayed behavioral changes are well recognized after anesthesia. Intravenous anesthesia may prevent emergence delirium. However, it has not been evaluated as a preventive strategy for delayed postoperative behavior changes. ⋯ The incidence of postoperative behavior changes in children undergoing ambulatory endoscopic procedures was similar when comparing intravenous with inhalation anesthesia. Children who experience emergence delirium might show a greater incidence of negative postoperative behavior changes.
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Paediatric anaesthesia · Mar 2023
Case ReportsDexmedetomidine Associated Diabetes Insipidus during Skull Base Surgery in a Pediatric Patient.
Diabetes insipidus is characterized by polyuria due to an inability to auto-regulate water balance resulting in dangerous metabolic derangements. Intraoperative anesthetics have been increasingly identified as a cause of diabetes insipidus in adult patients; however, it is rare in pediatrics. ⋯ Urine output drastically decreased following discontinuation of dexmedetomidine with complete resolution within 24 h. We conclude that this case of transient diabetes insipidus was associated with dexmedetomidine administration.
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Paediatric anaesthesia · Mar 2023
ReviewAssessing Pediatric Perioperative Affect: A Concise Review of Research and Clinically Relevant Scales.
Perioperative anxiety and distress are common in pediatric patients undergoing general anesthesia and increase the risk for immediate and long-term postoperative complications. This concise review outlines key research and clinically-relevant scales that measure pediatric perioperative affect. Strengths and weaknesses of each scale are highlighted. ⋯ Clinically-based anxiety measurement scales tend to be easier to use, however they require further testing before widespread standard utilization. The HRAD ± scale (Happy, Relaxed, Anxious, Distressed, with a yes/no answer to cooperation) may be a promising observational anxiety scale that is efficient and includes an assessment of compliance. Further studies are needed to refine a clinically-relevant anxiety assessment tool and appraise interventions that reduce perioperative distress.