Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2019
Incidence of adverse events attributable to bupivacaine liposome injectable suspension or plain bupivacaine for postoperative pain in pediatric surgical patients: A retrospective matched cohort analysis.
Surgical wound infiltration with local anesthetics is common as part of multimodal analgesia and enhanced recovery pathways in pediatric surgical patients. Liposomal bupivacaine can provide up to 92 hours of pain relief, and was approved by the U.S Food and Drug Administration for local infiltration in adults. It is also commonly used by pediatric surgeons, but its safety profile in this age group has not been described. ⋯ In a cohort of pediatric surgical patients receiving wound infiltration with either plain or liposomal bupivacaine, we identified no cases of local anesthetic systemic toxicity syndrome, and only few patients with any sign or symptom that could potentially be related to local anesthetic toxicity.
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Paediatric anaesthesia · Feb 2019
A quality improvement project to reduce postoperative adverse respiratory events and increase safety in the postanesthesia care unit of a pediatric institution.
Quality improvement methods can identify solutions and make dramatic improvements in patient safety during daily clinical care. The science of quality improvement in healthcare is still a very new concept in developing countries like China. ⋯ Using quality improvement methods, we successfully reduced the percentage of respiratory adverse events in the postanesthesia care unit. This helped to establish a safety culture among the anesthesia staff. Quality and safety improvement can be successfully implemented in developing countries like China with collaboration with quality improvement experts from more experienced institutions.
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Paediatric anaesthesia · Feb 2019
ReviewPain relief in the palm of your hand: Harnessing mobile health to manage pediatric pain.
The development and implementation of mobile health (mHealth) interventions provide an opportunity for more optimal management of pediatric pain in the home setting. Leveraging the popularity, mobility, and technological capabilities of digital mobile devices may reduce pediatric pain. Several mHealth applications have already been developed that target the reduction of acute and chronic pediatric pain by digitally delivering intervention strategies in an engaging manner, accumulating pain assessment data, facilitating patient-provider communication, and providing interactive training. ⋯ Recommendations are provided that advocate for continued advancement of pediatric pain mHealth implementation with an emphasis on robust scientific evaluation, a structured approach to development and design elements that enhance engagement. Increased awareness about the positive influence of mHealth along with the encouragement of researchers and healthcare providers to promote and develop mHealth programs has the potential to transform pediatric pain management. This merger of evidence-based pain management strategies and digital technology positions pediatric mHealth to have a profound impact by effectively augmenting standard of care and benefiting healthcare providers, parents, and especially children in need.
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Paediatric anaesthesia · Feb 2019
Observational StudyPostoperative behavioral changes in Chinese children undergoing hypospadias repair surgery: A prospective cohort study.
The perioperative period can be psychologically challenging, and children may exhibit behavioral changes following surgical anesthesia. It is unknown whether children in China have additional risk factors associated with negative behavioral changes. ⋯ For children undergoing hypospadias repair surgery in our institution, approximately three in five showed postoperative behavioral changes. In addition to a younger age and a higher maternal education, an emotional temperament is associated with a high incidence of negative postoperative behavioral changes.
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Paediatric anaesthesia · Feb 2019
Biography Historical ArticleThe Advancement of Pediatric Anesthesia Pharmacology: David Ryan Cook (Scions, Serendipity, and Six Degrees of Separation).
Dr David Ryan Cook, Professor Emeritus of Anesthesiology and Pharmacology at the University of Pittsburgh and Chief of Anesthesiology at Children's Hospital of Pittsburgh (1977-1999), is a pioneer in the field of pediatric anesthesiology and pharmacology. Dr Cook contributed significantly to the understanding of pharmacologic differences among infants, children, and adults. ⋯ He brought science to the art of anesthesia and enhanced the safety of pediatric perioperative care. Based on a 2017 interview with Dr Cook, this article outlines the development of his career and his contributions to the field of anesthesiology and pharmacology.