Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2023
A service evaluation of the impact of parental information provision on analgesia administration at home posttonsillectomy.
Tonsillectomy and adenotonsillectomy are together the most common pediatric surgical procedure and are increasingly performed as day cases. Postoperative pain is commonly severe for 1-2 weeks, but parental analgesia concerns lead to poor analgesia prescription compliance and under administration. This service evaluation assessed parental compliance with analgesia, elicited parental concerns, and obtained parental suggestions for improving the current written advice. ⋯ The breadth of unmet information needs identified in this service evaluation, alongside parental suggestions, will be used to improve the current written advice with the aim to improve the postoperative pain experience at home. These include information on length of analgesic course, safety of ibuprofen and paracetamol coadministration for analgesia, and details about morphine administration, including safety, side effects, and indication.
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Paediatric anaesthesia · Sep 2023
Observational StudyA machine-learning approach for decision support and risk stratification of pediatric perioperative patients based on the APRICOT dataset.
Pediatric anesthesia has evolved to a high level of patient safety, yet a small chance remains for serious perioperative complications, even in those traditionally considered at low risk. In practice, prediction of at-risk patients currently relies on the American Society of Anesthesiologists Physical Status (ASA-PS) score, despite reported inconsistencies with this method. ⋯ This work demonstrates that prediction of patients at low risk of critical PAEs can be made on an individual, rather than population-based, level by using machine learning. Our approach yielded two models that accommodate wide clinical variability and, with further development, are potentially generalizable to many surgical centers.
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Paediatric anaesthesia · Sep 2023
Modified technique for endobronchial blocker placement in pediatric patients undergoing thoracic surgery.
One lung ventilation (OLV) in small children can be achieved using an Arndt endobronchial blocker (AEBB), but it presents challenges. OLV during thoracic procedures provides better surgical conditions and postoperative outcomes. ⋯ The described technique allows for fast, safe, and reliable OLV while maintaining the ability to reposition the AEBB.