Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2018
Comparative StudyThe power of N-PASS, aEEG, and BIS in detecting different levels of sedation in neonates: A preliminary study.
Sedatives are essential drugs in every intensive care unit in order to ensure the patient's optimal level of comfort. Avoiding conditions of over- and under-sedation is a challenge in a neonatal intensive care setting. Drug administration could be optimized by the concomitant use of objective methods to assess the level of sedation. ⋯ While none of the three methods alone was able to precisely differentiate between different levels of sedation, we suggest that using a combination of amplitude-integrated Electroencephalogram and Neonatal Pain, Agitation and Sedation Scale can be useful to distinguish between light and deep sedation in neonatal patients.
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Paediatric anaesthesia · Dec 2018
Case ReportsMedical alert tattoos-A pinch of style along with patient safety.
The use of medical tattoos can potentially be life-saving. We present a 16-year-old patient who chose to tattoo a medical condition on her forearm. ⋯ To our knowledge, there are no published guidelines recommending an ideal location or symbology for a medical tattoo. Such guidelines would be useful to artists, as well as to medical personnel in emergencies if the patient has a tattoo.
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Paediatric anaesthesia · Dec 2018
Biography Historical ArticleAt the birth of pediatric anesthesia in Mexico: An interview with Dr. Estela Melman, a pioneering woman in medicine.
Dr. Estela Melman (1939-present), Professor in the Department of Anesthesiology, the American British Cowdray Medical Center, Mexico, is an influential pioneer who has shaped the scope and practice of pediatric anesthesia in Mexico and throughout the world. ⋯ Based on a series of interviews held with Dr. Melman between 2016 and 2017, this article reviews the remarkable career of a pioneering pediatric anesthesiologist.
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Paediatric anaesthesia · Nov 2018
A generalized multistage approach to oral and nasal intubation in infants with Pierre Robin sequence: A retrospective review.
Airway management in children with Pierre Robin sequence in the infantile period can be challenging and frequently requires specialized approaches. ⋯ In conclusion, we were able to use a ventilation-driven, multistaged approach using the unique properties of different supraglottic airways to facilitate oral and nasal intubation in 13 infants with Pierre Robin sequence.
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Paediatric anaesthesia · Nov 2018
Observational StudyNegligible impact of birth on renal function and drug metabolism.
Transition from the intrauterine to the extrauterine environment in neonates is associated with major changes in blood flow and oxygenation with consequent increases in metabolic functions. The additional impact of birth on renal function and drug metabolism above that predicted by postmenstrual age and allometry is uncertain. Increased clearance at birth could reduce analgesic effect attributable to a lowering of plasma concentration. These elimination processes can be described using the clearance concept. ⋯ Birth is associated with a small increase in clearance in addition to that described by postmenstrual age for common analgesic drugs cleared by glucuronide conjugation (morphine, paracetamol) or by the P450 cytochrome oxidase (tramadol) and renal systems. While the increase is of biological interest, it would not be expected to have any clinically relevant impact on renal function or drug dosing. The processes of maturation described by these models are potentially applicable to any drug elimination process.