Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2016
Incidence and risk factors for postoperative vomiting following atrial septal defect repair in children.
The incidence and risk factors for postoperative vomiting (POV) after pediatric cardiac surgery has not been studied. ⋯ The incidence of POV in children undergoing surgical ASD repair was 37.5%. Age ≥4 years and CPB time ≥51 min were identified as independent predictors.
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Paediatric anaesthesia · Jun 2016
A pilot study of dexmedetomidine sedation and caudal anesthesia for inguinal hernia repair in infants.
Recent concerns regarding possible long-term effects of early anesthesia exposure on neurodevelopment in children have provided an impetus to explore alternative anesthetic techniques using potentially neuroprotective agents. Dexmedetomidine has not been implicated in anesthesia-induced neurotoxicity and has been shown to be neuroprotective in preclinical studies. We describe a case series of 50 neonates and infants who received dexmedetomidine sedation with caudal anesthesia instead of general endotracheal anesthesia for inguinal hernia surgery. ⋯ Dexmedetomidine sedation with caudal anesthesia is a feasible alternative to spinal or general anesthesia in selected infants undergoing uncomplicated hernia surgery. It avoids the need for endotracheal intubation and may be potentially beneficial in avoiding the unknown effects of general anesthesia on neurodevelopment.
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Paediatric anaesthesia · Jun 2016
Utility of screening questionnaire, obesity, neck circumference, and sleep polysomnography to predict sleep-disordered breathing in children and adolescents.
Polysomnography (PSG) remains the gold standard for diagnosing obstructive sleep apnea (OSA) and sleep-disordered breathing in children. Yet, simple screening tools are needed as it is not feasible to perform PSG in all patients with possible OSA. ⋯ We developed a six-question scale with good predictive utility for OSA. These findings may contribute to developing a preoperative clinical tool to help clinicians identify children with OSA for determining risk stratification and postoperative disposition.
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Paediatric anaesthesia · Jun 2016
Observational StudyEvaluation of the Explorer Endoscopy Mask(©) for esogastroduodenoscopy in children: a retrospective study of 173 cases.
The aim of this study was to evaluate the usability and safety of the Explorer Endoscopy Mask(®) (EM) as an alternative to endotracheal intubation in children undergoing elective esogastroduodenoscopy (EGD) under general anesthesia (GA). ⋯ Our data support the EM use in pediatric EGD. There were few transient respiratory adverse events which were easily solved with minor interventions.
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Lung isolation in the pediatric population can be problematic. The diameter and length of the right and left mainstem bronchi are not well described in young children. Information regarding these measurements may help determine the appropriate size of endotracheal tubes for endobronchial intubation as well as the development of lung isolation devices for the pediatric population. The present study is based on computed tomography (CT) measurements to evaluate airway dimensions. The goal of this study was to define the relationship between the diameters of the left mainstem bronchus (LMSB) and the cricoid ring, and to study the effect of age, weight, and height on these dimensions. ⋯ The cricoid to LMSB ratio (relationship) remains constant with respect to age, height, and weight.