Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2020
Intravenous Dexmedetomidine Sedation for Magnetoencephalography: A Retrospective Study.
Magnetoencephalography (MEG) plays a preponderant role in the preoperative assessment of patients with drug-resistant epilepsy (DRE). However, the magnetoencephalography of patients with drug-resistant epilepsy can be difficult without sedation and/or general anesthesia. Our objective is to describe our experience with intravenous dexmedetomidine as sedation for magnetoencephalography and its effect, if any, on the ability to recognize epileptic spikes. ⋯ Our results suggest that dexmedetomidine-based protocol provides reliable sedation in children undergoing MEG scanning because of the high success rate, limited interictal artifacts, and minimal impacts on spike frequency.
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Paediatric anaesthesia · Jul 2020
The Effect of Intraoperative Methadone During Pediatric Cardiac Surgery on Postoperative Opioid Requirements.
Pain control in pediatric patients undergoing cardiac surgery presents a unique challenge. Postoperatively, many of these patients require long-term opioid infusions and sedation leading to need for prolonged weaning from opioids and longer hospital stays. We hypothesized that intravenous methadone as the sole opioid in children having cardiac surgery with cardiopulmonary bypass would improve perioperative pain control and decrease overall perioperative use of opioid analgesics and sedatives. ⋯ The use of intraoperative methadone appears to be a reasonable alternative to the use of fentanyl with potential other benefits both intra- and postoperatively of decreased total dose of opioids and other sedatives. Future studies will assess for any improvement in total postoperative opioid requirements during the total hospital stay, and potential use of methadone by the ICU team.
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Paediatric anaesthesia · Jul 2020
Association of Tidal Volume during Mechanical Ventilation with Postoperative Pulmonary Complications in Pediatric Patients Undergoing Major Scoliosis Surgery.
The use of lung-protective ventilation strategies with low tidal volumes may reduce the occurrence of postoperative pulmonary complications. However, evidence of the association of intraoperative tidal volume settings with pulmonary complications in pediatric patients undergoing major spinal surgery is insufficient. ⋯ In pediatric patients undergoing major spinal surgery, high tidal volume was associated with an elevated risk of postoperative pulmonary complications. However, the effect of tidal volume on pulmonary outcomes in the young subgroup (≤3 years) differed from that in the old (>3 years). Such information may help to optimize ventilation strategy for children of different ages.
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Paediatric anaesthesia · Jul 2020
Incidence and risk factors of preoperative anxiety in Spanish-speaking children living in a Spanish-speaking country.
Most research on preoperative anxiety has focused on non-Latino populations. A study performed in the USA found that children from Spanish-speaking Latino families experienced higher anxiety than children from English-speaking families. ⋯ Spanish-speaking children undergoing elective surgery in their home country experienced significant rates of preoperative anxiety. Parental anxiety and previous negative surgical experience were risk factors associated with higher anxiety levels.
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Paediatric anaesthesia · Jul 2020
East/West Visiting Scholars in Pediatric Anesthesia Program (ViSiPAP): Developing Tomorrow's Pediatric Anesthesia Leaders.
Promoting and retaining junior faculty are major challenges for many medical schools. High clinical workloads often limit time for scholarly projects and academic development, especially in anesthesiology. To address this, we created the East/West Visiting Scholars in Pediatric Anesthesia Program (ViSiPAP). ⋯ Moreover, ViSiPAP provides opportunities for women and underrepresented in medicine faculty. This program can help develop today's junior faculty into tomorrow's leaders in pediatric anesthesia. We advocate for expanding the concept of ViSiPAP to other institutions in academic medicine.