Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2020
The Relationship between Parental Factors, Child Symptom Profile and Persistent Postoperative Pain Interference and Analgesic Use in Children.
Both parental and child factors have been previously associated with persistent or recurrent postoperative pain in children. Yet, little is known about the relative contribution of parent factors or whether child symptom factors might impact the association between parent factors and long-term pain. The aim of this study was to explore the associations between parent factors, child symptomology, and the child's long-term pain outcomes after surgery. ⋯ These findings suggest that the relationship between parent factors and long-term postoperative pain outcomes may be dependent on the child's symptom profile at baseline. Since there may be bidirectional relationships between parent and child factors, interventions to mitigate long-term pain should address child symptoms as well as parental factors.
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Paediatric anaesthesia · Dec 2020
Sjögren-Larsson Syndrome: Anesthetic Considerations and Practical Recommendations.
Sjögren-Larsson syndrome is a rare inherited neurocutaneous disorder characterized by congenital ichthyosis, spasticity, intellectual disability, seizures, and ophthalmologic changes. Most individuals with Sjögren-Larsson syndrome live well into adulthood and often require surgical intervention to manage their symptomatology. ⋯ We found that anesthesia can be safely administered in patients with Sjögren-Larsson syndrome. Providers should be aware of anesthetic management issues in Sjögren-Larsson syndrome including challenges placing and securing lines and monitors secondary to the ichthyosis.
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Paediatric anaesthesia · Dec 2020
Outcomes from Wake Up Safe, the Pediatric Anesthesia Quality Improvement Initiative.
Wake Up Safe, a Patient Safety Organization founded by the Society for Pediatric Anesthesia, collects data on serious adverse events along with demographic data from all pediatric patients receiving anesthesia care at participating institutions. This report reviews all events occurring between 2010 and 2015 and focuses on common adverse events that are anesthesia-related. ⋯ The majority of anesthesia-related serious adverse events reported to the Wake Up Safe database are preventable. Medication events are the most common anesthesia-related adverse events. Innovations aimed at decreasing medication events may be the most impactful.
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Paediatric anaesthesia · Dec 2020
The Safety Profile and Effectiveness of Propofol-Remifentanil Mixtures for Total Intravenous Anaesthesia in Children.
Total intravenous anesthesia is used in less than 10% of operations in the UK. Many pediatric anesthetists in the UK and Ireland administer total intravenous anesthesia to children using a mixture of propofol and remifentanil in the same syringe. This unlicensed drug has not been studied clinically, because of lack of Medicines and Healthcare products Regulatory Agency (UK) or Food and Drug Administration (US) approval to undertake such studies. ⋯ These data demonstrate that effective anesthesia can be administered to pediatric patients undergoing a wide range of procedures using mixtures of propofol and remifentanil. Serious, related, unexpected adverse events requiring intervention had a low incidence and were largely due to predictable effects of the drugs being administered. A ≤5 μg mL-1 remifentanil concentration is associated with proportionately less complications.
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Paediatric anaesthesia · Dec 2020
Comparing oscillometric non-invasive and invasive intra-arterial blood pressure monitoring in term neonates under general anesthesia: A retrospective study.
Oscillometric noninvasive blood pressure and/or invasive intra-arterial blood pressure are commonly used to measure the systolic, diastolic, and mean components of blood pressure. Agreement between the two methods has been reported in adults, children, and infants, but rarely in neonates, especially under general anesthesia. ⋯ Based on the bias and percentage error, the mean blood pressure exhibited the most acceptable agreement between oscillometric noninvasive and invasive intra-arterial blood pressure monitoring in term neonates under general anesthesia. However, during hypertension or hypotension, there was a large discrepancy between the two methods.