Paediatric anaesthesia
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Children with chronic pain often undergo surgery and effective perioperative management of their pain can be challenging. Identification of the pediatric chronic pain patient preoperatively and development of a perioperative pain plan may help ensure a safer and more comfortable perioperative course. Successful management usually requires multiple different classes of analgesics, regional anesthesia, and adjunctive nonpharmacological therapies. Neuropathic and oncological pain can be especially difficult to treat and usually requires an individualized approach.
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Paediatric anaesthesia · Aug 2016
Association of elevated preoperative blood pressure with preincision hypotension in pediatric surgical patients.
High blood pressure (BP) in childhood is associated with left ventricular hypertrophy and abnormal vascular reactivity even in apparently healthy children. This study examined the prevalence of high BP in children undergoing elective noncardiac operations. We also determined the association of preoperative high BP with preincision hypotension (PIH). ⋯ In children, preoperative high BP is an independent predictor of PIH. Although the longtime consequences of high BP are well known, this report provides the first intraoperative evidence of adverse event associated with preoperative high BP in children. Mechanisms underlying this hypotensive response are unclear.
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Paediatric anaesthesia · Aug 2016
Randomized Controlled TrialCould acupuncture be an adequate alternative to dexamethasone in pediatric tonsillectomy?
Usage of nonpharmacological treatment contributes to an overall patient well-being, assisting in physical and emotional healing. Acupuncture has been reported to be useful in reducing early postoperative vomiting (POV) and attenuating postoperative pain. ⋯ Acupuncture at P6 bilaterally and CV13 provided similar antiemetic effect to dexamethasone in children undergoing tonsillectomy.