Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2009
ReviewImpact of anesthetic agents on cerebrovascular physiology in children.
The role of the pediatric neuroanesthetist is to provide comprehensive care to children with neurologic pathologies. The cerebral physiology is influenced by the developmental stage of the child. The understanding of the effects of anesthetic agents on the physiology of cerebral vasculature in the pediatric population has significantly increased in the past decade allowing a more rationale decision making in anesthesia management. Although no single anesthetic technique can be recommended, sound knowledge of the principles of cerebral physiology and anesthetic neuropharmacology will facilitate the care of pediatric neurosurgical patients.
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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.
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Paediatric anaesthesia · Jan 2009
ReviewThe World Federation of Societies of Anaesthesiologists and Pediatric Anesthesia.
The World Federation of Societies of Anaesthesiologists (WFSA) is an organization whose principal goal is to improve the standard of anesthesia worldwide. The education and pediatric committees focus on the needs of pediatric patients in developing countries. Subspecialty training in pediatric anesthesia is supported in several regions. The publications committee supports the distribution of textbooks in pediatric anesthesia.
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Paediatric anaesthesia · Jan 2009
ReviewPlastic and reconstructive surgery in Uganda--10 years experience.
We describe our experience of working in plastic and reconstructive surgery in Uganda over the last 10 years. There is a high burden of disease, a health system that is under resourced, and few qualified physicians to provide healthcare for a principally rural population. Training the physicians of the future is essential. ⋯ Subsidized up-country visits by trained specialists with the appropriate equipment are required to provide a service for the rural poor. There appears to be a high mortality rate in babies with unrepaired cleft palate, probably due to feeding difficulties in an environment where intercurrent illness is common. We now offer nutritional support with early combined cleft lip and palate repair in these babies, a practice that has a high success rate and may be suited to other specialist units in the developing world.
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Paediatric anaesthesia · Jan 2009
ReviewAnesthesia for thoracic surgery in children in developing countries.
Anesthesia for surgery on the lung and intra-thoracic structures requires a high level of expertise. In the developing world, patients are often poor, anemic and malnourished. ⋯ Surgery is often mandated in spite of inadequate resources. Maintaining the safety of the patient while treating them within the limits of our resources is a continuing challenge.