Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2020
Multicenter StudyPerioperative aspiration events in children: a report from the Wake-Up Safe Collaborative.
Perioperative aspiration, while rare, is a serious complication of anesthetic care. Consequences of aspiration may include physical obstruction, wheezing, and pneumonia, resulting in mild to severe hypoxemia and even death. ⋯ Although infrequent, death was reported as a consequence of perioperative aspiration in two patients. The frequency with which NPO violations were identified as a potential cause of aspiration highlights the struggles institutions face with adherence to NPO regulations, as these cases may be preventable. Furthermore, preventive measures may be needed to address other common causes of aspiration, such as gastrointestinal comorbid conditions.
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Paediatric anaesthesia · Jun 2020
ReviewElectronic cigarettes: a narrative review of the implications for the pediatric anesthesiologist.
The use of electronic cigarettes (EC) is increasing and the number of EC publications is rapidly growing. While some health organizations focus on the harmful effects of using EC (vaping), others promote the benefits of ECs as a less harmful alternative to smoking tobacco. ⋯ This narrative review summarizes current knowledge and recommendations regarding the risks of EC relevant to the anesthesiologist and the use of ECs as a step-down option from tobacco. We provide guidance on the management of vaping patients in the perioperative period.
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Paediatric anaesthesia · Jun 2020
Anaesthesia for bilateral pulmonary banding as part of hybrid-stage I approach palliating neonates with hypoplastic left heart syndrome.
Neonatal management of patients with hypoplastic left heart syndrome and complex remains a challenging task, whereby the "hybrid" palliation is often reserved for high-risk patients as a "rescue" procedure. ⋯ Considering a learning curve, anesthesia for surgical bilateral pulmonary artery banding palliating patients with hypoplastic left heart syndrome and complex can safely be performed, independent from the preoperative clinical status.
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Paediatric anaesthesia · Jun 2020
The extent of cranio-caudal spread within the erector spinae fascial plane space using computed tomography scanning in a neonatal cadaver.
The erector spinae plane block (ESP) is a novel approach for blockade of the spinal nerves in infants, children, and adults. Until recently, the gold standard for truncal procedures includes the paravertebral and epidural blocks. However, the exact mechanism by which this blockade is achieved is subject to debate. ⋯ The erector spinae plane block is a versatile technique that can be part of the multimodal postoperative analgesic strategy for truncal surgery. In this study, contrast material dye was tracked over four vertebral levels in the paravertebral space (suggesting an approximate volume of 0.5-0.6 mL per dermatome).