Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2017
The association between caudal anesthesia and increased risk of postoperative surgical complications in boys undergoing hypospadias repair.
Recent reports have suggested that caudal anesthesia may be associated with an increased risk of postoperative surgical complications. We examined our experience with caudal anesthesia in hypospadias repair to evaluate for increased risk of urethrocutaneous fistula or glanular dehiscence. ⋯ In our experience, caudal anesthesia was associated with an over 13-fold increase in the odds of developing postoperative surgical complications in boys undergoing hypospadias repair even after adjusting for urethral meatus location. Until further investigation occurs, clinicians should carefully consider the use of caudal anesthesia for children undergoing hypospadias repair.
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Paediatric anaesthesia · Jul 2017
Incidence and predictors of massive bleeding in children undergoing liver transplantation: A single-center retrospective analysis.
Liver transplantation represents a major surgery involving a highly vascular organ. Reports defining the scope of bleeding in pediatric liver transplants are few. ⋯ Pediatric liver transplantation is associated with substantial blood loss and a significant blood product transfusion burden. A 43% incidence of massive bleeding is reported. Further efforts are needed to improve bleeding management in this high-risk population.
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Paediatric anaesthesia · Jul 2017
Risk factors for perioperative mortality and transfusion in sacrococcygeal teratoma resections.
Sacrococcygeal teratomas are a common congenital tumor. Surgical resection can occur in utero, in the neonatal period, or in the postneonatal period. ⋯ Prematurity is associated with increased intraoperative and 30-day mortality. Noncystic tumor morphology was the only significant factor associated with transfusion volume and all six patients who died had transfusion volumes of 240 ml·kg-1 or greater. In these patients at high risk of mortality due to blood loss, the anesthesia team should be prepared to manage massive transfusion and coagulopathy with blood components and pharmacologic measures.
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Paediatric anaesthesia · Jul 2017
Influence of caudal block on postoperative oliguria in infants undergoing bilateral ureteroneocystostomy: a retrospective analysis.
Caudal block has been widely used in children undergoing genitourinary surgery. However, the influence of caudal block on postoperative oliguria is unclear. ⋯ Caudal block may be associated with postoperative oliguria in infants undergoing ureteroneocystostomy.