Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2022
Multicenter Study Observational StudyPerioperative critical events and morbidity associated with anesthesia in early life: subgroup analysis of United Kingdom participation in the neonate and children audit of anesthesia practice in Europe (NECTARINE) prospective multicenter observational study.
The NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) prospective observational study reported critical events requiring intervention during 35.2% of 6542 anesthetic episodes in 5609 infants up to 60 weeks postmenstrual age. The United Kingdom (UK) was one of 31 participating countries. ⋯ Perioperative critical events and co-morbidities are common in neonates and young infants. Thirty-day morbidity and mortality data did not demonstrate national differences in outcome. Identifying factors associated with increased risk informs preoperative assessment, resource allocation, and discussions between clinicians and families.
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Paediatric anaesthesia · Jul 2022
Randomized Controlled TrialA Comparison of the Oropharyngeal Leak Pressure between Three Second Generation Supraglottic Airway Devices During Laparoscopic Surgery in Pediatric Patients.
Previous studies have shown Proseal LMA and I gel similar to endotracheal intubation in ventilatory ability in pediatric laparoscopic surgeries. ⋯ I gel had a higher oropharyngeal leak pressure than the other two supraglottic airway devices and therefore may represent a better choice in situations where higher ventilatory pressures may be necessary, for example, in extremes of weight trendelenburg position, etc. CLINICAL TRIAL IDENTIFIER: Clinical trial registry of India (CTRI/2018/11/016445).
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Paediatric anaesthesia · Jul 2022
Comprehensive Risk Assessments and Anesthetic Management for Children with Osteogenesis Imperfecta: A Retrospective Review of 252 Orthopedic Procedures Over 5 Years.
Major anesthetic risks arise in orthopedic surgeries for children with osteogenesis imperfecta, a rare genetically inherited condition presenting diverse skeletal issues. ⋯ Anesthesia for children with osteogenesis imperfecta undergoing complex orthopedic procedures was challenging. Proper anesthesia planning was essential for both intraoperative management and postoperative analgesia. Age, surgical duration, and use of sevoflurane for maintenance impacted the intraoperative temperature most, and massive blood loss was not uncommon. The risks for airway or regional anesthesia difficulties were low. Pain scores could be controlled to be ≤3 via multiple techniques.
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Paediatric anaesthesia · Jul 2022
Observational StudyTemperature change in children undergoing magnetic resonance imaging - an observational cohort study.
An increasing number of children undergo magnetic resonance imaging requiring anesthesia or sedation to ensure their immobility; however, magnetic resonance imaging may increase body temperature whereas sedation or anesthesia may decrease it. We investigated changes in body temperature in children who underwent sedation or anesthesia for magnetic resonance imaging. ⋯ In this study of sedated or anesthetized children undergoing magnetic resonance imaging, clinically relevant increases in body temperature above 0.5°C were only found in a few patients. However, longer imaging duration tended to be associated with increased body temperature.
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Paediatric anaesthesia · Jul 2022
Compatibility of intravenous acetaminophen with morphine, fentanyl and ketamine in acute pediatric pain setting.
Intravenous acetaminophen and opioid analgesics are routinely given concurrently to children after major surgery, where intravenous access can be limited. There is limited information about the compatibility of acetaminophen with opioid analgesics and ketamine in concentrations commonly used in pediatric setting. ⋯ Our data demonstrated the stability of acetaminophen, in combination with fentanyl, morphine, and ketamine at clinical concentrations used in acute pediatric pain setting.