Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2020
Review Meta AnalysisRespiratory and haemodynamic perioperative adverse events in intravenous versus inhalational induction in paediatric anaesthesia: a systematic review and meta-analysis.
Perioperative respiratory and hemodynamic adverse events are still a cause of morbidity and mortality in pediatric anesthesia. It has been suggested that volatile agents might be associated with more respiratory adverse events compared to intravenous agents (eg, propofol), which have been associated with a higher risk of bradycardia compared to volatile agents. We performed a systematic review and meta-analysis to evaluate the risk of perioperative hemodynamic and respiratory adverse events, comparing intravenous induction with inhalational induction in pediatric anesthesia. ⋯ More respiratory adverse events during and after inhalation induction were found, in particular in children with multiple risk factors for respiratory adverse events. This did not reach significance. Future research should include a large randomized controlled trial comparing inhalation and intravenous induction with respiratory and hemodynamic adverse events as primary outcome and adequately blinded outcome assessors.
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Paediatric anaesthesia · May 2020
Review Meta AnalysisThe effectiveness of PC6 acupuncture in the prevention of postoperative nausea and vomiting in children- A systematic review and meta-analysis.
A growing number of studies have demonstrated the effectiveness of acupuncture in preventing and treating postoperative nausea and vomiting. Here, we used meta-analysis to confirm these benefits in children and to determine the optimal time to perform this treatment. ⋯ Acupuncture reduces the incidence of postoperative nausea and vomiting as well as the utilization of antiemetic remedies, particularly during the first 4 hours following the operation. Acupuncture performed before anesthesia was demonstrated to be the most ideal intervention time for children.
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Paediatric anaesthesia · Apr 2020
Review Meta AnalysisNeuromuscular blocking agents for tracheal intubation in pediatric patients: A systematic review and meta-analysis.
The benefit of using neuromuscular-blocking agents to facilitate tracheal intubation in pediatric patients remains unclear due to variations in design, treatments, and results among trials. By combining the available evidence, we aimed to establish whether scientific findings are consistent and can be generalized across various populations, settings, and treatments. ⋯ The use of a neuromuscular-blocking agent during light-to-moderate depth of anesthesia can improve the quality as well as the success rate of tracheal intubation and is associated with better hemodynamic stability during induction of anesthesia.
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Paediatric anaesthesia · Dec 2019
Meta AnalysisThe Effect of Ketamine on Emergence Agitation in Children: A Systematic Review and Meta-analysis.
Although there is some evidence that ketamine may reduce emergence delirium in children, it is generally low quality and inconsistent, and practice change is not recommended.
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Paediatric anaesthesia · Oct 2019
Meta AnalysisSafety and efficacy of clonidine on postoperative vomiting and pain in pediatric ophthalmic surgery: A systematic review and meta-analysis.
Postoperative vomiting and pain are common, unpleasant phenomena in pediatric patients undergoing ophthalmic surgery. Clonidine has antiemetic and analgesic properties and thus may be used as premedication to reduce postoperative vomiting and pain. ⋯ Compared to placebo or benzodiazepine, clonidine premedication was effective in reducing postoperative vomiting in pediatric patients undergoing ophthalmic surgery. Clonidine premedication also provided more reduction in postoperative pain when compared to placebo. The use of clonidine premedication was not associated with adverse hemodynamic events.