Paediatric anaesthesia
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Paediatric anaesthesia · May 2015
Historical ArticleThe development of pediatric anesthesia and intensive care in Scandinavia.
The initiation and development of pediatric anesthesia and intensive care have much in common in the Scandinavian countries. The five countries had to initiate close relations and cooperation in all medical disciplines. The pediatric anesthesia subspecialty took its first steps after the Second World War. ⋯ Although pediatric anesthesia/intensive care is not a separate specialty, an 'informal accreditation' for a specialist position is obtained after training. The pleasure of working in a relatively small group of devoted colleagues and staff has persisted from the pioneering years. It is still one of the most inspiring and pleasant gifts for those working in this demanding specialty.
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Paediatric anaesthesia · May 2015
Selection of subspecialty fellows in anesthesia for pediatric anesthesia: a national survey of program directors in the United States.
Several studies have investigated the selection process for medical students, residents, and fellows across different specialties. Currently, the selection criteria used by pediatric anesthesia program directors to select prospective pediatric anesthesia fellows are unknown. ⋯ A minority of pediatric fellowship program directors rated prior research experience as an important factor in the selection of prospective fellows. The lack of emphasis on research qualities for fellows is potentially concerning for the future of our specialty.
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Paediatric anaesthesia · May 2015
Observational StudyEmergence delirium, pain or both? a challenge for clinicians.
Children commonly display early postoperative negative behavior (e-PONB) after general anesthesia, which includes emergence delirium (ED), discomfort, temperament, and pain. However, it is often difficult for the caregiver to discriminate between various aspects of e-PONB. ⋯ It is difficult to differentiate between ED and pain using FLACC and PAED scores. 'No eye contact', 'No purposeful action', and 'No awareness of surroundings' significantly correlated with ED. 'Inconsolability' and 'Restlessness' are not reliable enough to identify pain or ED in the first 15 min after awakening.
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Paediatric anaesthesia · May 2015
Randomized Controlled TrialEffects of a restrictive fluid regimen in pediatric patients undergoing major abdominal surgery.
To investigate the effects of restrictive fluid regimen during major abdominal surgery in pediatric patients. ⋯ Volume preload corresponding with an estimated interstitial space replacement was suitable for application to pediatric patients undergoing major abdominal surgery.
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Paediatric anaesthesia · May 2015
Should we abandon landmark-based technique for caudal anesthesia in neonates and infants?
Caudal anesthesia is a landmark-based technique with ultrasound guidance occasionally used in the absence of landmarks. The current surface landmark remains a popular approach due to its desirable success rate. However, incomplete ossification of the posterior vertebral elements can make this procedure for neonatal caudal anesthesia difficult. The aim of this study was to describe the anatomical relationship of the posterior superior iliac spines (PSISs) to the sacral cornua in infants using ultrasound. ⋯ This study showed that the current landmark (equilateral triangle) for infant caudal anesthesia is unreliable. Importantly, the sacral hiatus is clinically identifiable only if the sacral cornua are palpable; otherwise, using ultrasound is essential.