Paediatric anaesthesia
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Paediatric anaesthesia · May 2009
ReviewTranscutaneous carbon dioxide monitoring in infants and children.
To review the technology required for and the applications of transcutaneous carbon dioxide (TC-CO2) monitoring in infants and children. ⋯ Transcutaneous carbon dioxide monitoring may be a useful adjunct in various clinical scenarios in infants and children. It should be viewed as a complimentary technology and may be used in combination with ET-CO2 monitoring.
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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
Review Case ReportsAnesthesia in children with mastocytosis--a case based review.
Mastocytosis is a rare heterogeneous disease of bone marrow origin which arises as a consequence of abnormal growth and/or accumulation of clonal mast cells in one or more organs. Sixty-five percent of patients with mastocytosis are children in whom it usually regresses around puberty. Adult patients with mastocytosis have been identified as at high risk of widespread mast cell degranulation in the perioperative period, this finding has not been reported in pediatric patients. This information has been repeated in mastocytosis websites where it has the potential to cause disproportionate alarm in parents. ⋯ The risks for most pediatric patients are overstated by mastocytosis websites. Most pediatric patients with CM do not appear to be at risk of widespread mast cell degranulation during anesthesia but because of the small number of cases reported, the risk cannot be ascertained with confidence. Children with SM and a high baseline serum tryptase (marker of mast cell burden) may merit extra precautions but experience in this subgroup is even more limited. Drugs which cause minimal histamine release can be selected from the range of drugs available in most pediatric centers without compromise to technique.