Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2020
Observational StudyDuration of preoperative clear fluid fasting and peripheral intravenous catheterization in children: a single-center observational cohort study of 9,693 patients.
Children routinely undergo inhalational induction of general anesthesia. Intravenous line placement typically occurs after induction of anesthesia and can be challenging, particularly in infants and young children. ⋯ Clear liquid fasting time was not associated with multiple insertion attempts for intravenous line insertion in children receiving general anesthesia. Factors such as patient age, ethnicity, time of day of induction of anesthesia, and American Society of Anesthesiologists Physical Status classification show a greater association with the risk of multiple intravenous line insertion attempts.
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Paediatric anaesthesia · Feb 2020
Incidence and Predictors of Postoperative Nausea and Vomiting in Children Undergoing Electrophysiology Ablation Procedures.
Postoperative nausea and vomiting remains a significant concern for patients undergoing general anesthesia for percutaneous radiofrequency catheter ablation and cryoablation for tachyarrhythmias. ⋯ A shorter anesthetic time and a subhypnotic propofol infusion were predictive of a lower rate of postoperative vomiting in patients undergoing general anesthesia for electrophysiologic ablation procedures.
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Paediatric anaesthesia · Feb 2020
Case ReportsDexmedetomidine Infusion Overdose during Anaesthesia: A Case Report.
A 12-kg infant was given intravenous dexmedetomidine 0.2 µg kg-1 min-1 as an adjunct for general anesthesia. The 60-fold increase in dexmedetomidine infusion rate caused a biphasic response with initial hypertension followed by bradycardia and hypotension requiring inotropic support. No postoperative or long-term sequelae were noted. Dexmedetomidine infusion is usually delivered as µg kg-1 h-1 .
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Paediatric anaesthesia · Feb 2020
Case ReportsThoracic Caudal Epidural Catheter Localization Using Ultrasound Guidance.
Caudal epidural catheters provide exceptional analgesia while avoiding or minimizing opioids. Historically, the catheter tip location (dermatomal level) was estimated or verified via epidurogram. ⋯ Ponde et al demonstrated that catheter insertion depth was longer when using ultrasound guidance than when estimated by external measurement. We report a simple yet novel ultrasound approach for catheter localization.
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Paediatric anaesthesia · Feb 2020
Does a two-minute mini-fluid challenge predict fluid responsiveness in pediatric patients under general anesthesia?
Very little evidence for predictive markers of fluid responsiveness has been reported in children as compared to adults. The impact of hypovolemia or hypervolemia on morbidity has driven interest in the fluid challenge titration strategy. ⋯ ΔVTIminiFC weakly predicted the effects of a fluid challenge of 15 mL kg-1 of crystalloid in anesthetized children under controlled mechanical ventilation.