Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2015
Randomized Controlled TrialCombination of warming blanket and prewarmed intravenous infusion is effective for rewarming in infants with postoperative hypothermia in China.
Postoperative hypothermia in the postanesthesia care unit (PACU) in neonates and infants is a well-known serious complication as it can increase the risk of blood loss, wound infections, and cardiac arrhythmias. ⋯ The combination of conventional blanket rewarming and prewarmed i.v. infusion was shown to be an effective rewarming method for hypothermic infants in China.
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Paediatric anaesthesia · Nov 2015
Comparative StudyA retrospective comparison of ropivacaine and 2-chloroprocaine continuous thoracic epidural analgesia for management of postthoracotomy pain in infants.
Continuous thoracic epidural analgesia is useful in the management of infants following thoracotomy. Concerns about drug accumulation and toxicity limit the amount of amide local anesthetics that can be delivered. Continuous epidural infusions of the ester local anesthetic chloroprocaine result in little drug accumulation allowing for higher infusion rates. We retrospectively compared patients managed with 1.5% 2- chloroprocaine or 0.1% ropivacaine epidural infusions to determine if the increased infusion rate resulted in similar or improved analgesia. ⋯ The use of 2-chloroprocaine for continuous epidural infusion in infants following thoracotomy was not inferior to ropivacaine and there was weak evidence for a reduction in opioid consumption in the first 24 h postoperatively. However, the 2-chloroprocaine group was more likely to receive ketorolac.
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Paediatric anaesthesia · Nov 2015
Randomized Controlled TrialThe state of UK pediatric anesthesia: a survey of National Health Service activity.
This secondary analysis of the 2013 United Kingdom National Health Service (NHS) Anaesthesia Activity Survey of the Fifth National Audit Project (of the Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland) shows pediatric anesthesia activity in detail. A local coordinator (LC) in every NHS hospital collected data on patients undergoing any procedure managed by an anesthetist. Questionnaires had 30 question categories. ⋯ Almost all ASA 4 and 5 children (89%) and infants (92%) were managed in specialist hospitals. 'Awake' cases and sedation accounted for only 2% of cases. There were notable differences in demography and anesthetic care compared with adults and between different age groups of children. These data enable analysis of the current state of UK pediatric anesthetic practice and highlight differences between pediatric and adult services.
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Paediatric anaesthesia · Nov 2015
Middle finger length-based tracheal intubation depth improves the rate of appropriate tube placement in children.
It is challenging for anesthetists to determine the optimal tracheal intubation depth in children. We hypothesize that a measure three times the length of the middle finger can be used for predicting tracheal tube depth in children. ⋯ Our data indicate that the appropriate tube placement rate can be improved by using three times the middle finger length as the tracheal intubation depth in children.