Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2009
ReviewUltrasound guided transversus abdominis plane block in infants, children and adolescents: a simple procedural guidance for their performance.
The transversus abdominis plane block (TAP) has been described recently for pain management following abdominal surgery. Although many techniques have been described using anatomical landmarks, a simple ultrasound (US) guidance technique for the block has not been described in children. ⋯ We describe in this article, a user-friendly approach to the placement of a TAP block in infants, children and adolescents. Further pharmacokinetic data has to be obtained for actual dosing for these blocks in infants and children.
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Paediatric anaesthesia · Mar 2009
ReviewAnesthetic considerations for major burn injury in pediatric patients.
Major burn injury remains a significant cause of morbidity and mortality in pediatric patients. With advances in burn care and with the development of experienced multi-disciplinary teams at regionalized burn centers, many children are surviving severe burn injury. ⋯ These children provide several anesthetic challenges, such as difficult airways, difficult vascular access, fluid and electrolyte imbalances, altered temperature regulation, sepsis, cardiovascular instability, and increased requirements of muscle relaxants and opioids. The anesthesia provider must understand the physiologic derangements that occur with severe burn injury as well as the subsequent anesthetic implications.
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Paediatric anaesthesia · Feb 2009
ReviewAre peripheral and neuraxial blocks with ultrasound guidance more effective and safe in children?
The efficacy and safety of ultrasound guided (USG) pediatric peripheral nerve and neuraxial blocks in children have not been evaluated. In this review, we have looked at the success rate, efficacy and complications with USG peripheral nerve blocks and compared with nerve stimulation or anatomical landmark based techniques in children. ⋯ Clinical studies in children suggest that US guidance has some advantages over more traditional nerve stimulation-based techniques for regional block. However, the advantage of US guidance on safety over traditional has not been adequately demonstrated in children except ilio-inguinal blocks.