Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2018
Multicenter Study Clinical TrialAcetaminophen, ibuprofen, and tramadol analgesic interactions after adenotonsillectomy.
The impact of tramadol in children given acetaminophen-ibuprofen combination therapy is uncertain in acute pediatric pain management. A model describing the interaction between these three drugs would be useful to understand the role of supplemental analgesic therapy. ⋯ Ibuprofen has an EC50 for analgesia in children similar to that of adults (3.95 mg/L; 95%CI 2.57-7.53, vs 5-10 mg/L adults). The maximum effect from combination therapy (ie, 65% reduction in pain score) achieves satisfactory analgesia with commonly used doses but increased dose adds little additional benefit. The addition of tramadol to this analgesic mixture prolongs analgesia duration.
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Paediatric anaesthesia · Aug 2018
Multicenter Study Observational StudyPerioperative outcomes and management in midface advancement surgery: a multicenter observational descriptive study from the Pediatric Craniofacial Collaborative Group.
The evolution of Le Fort III and Monobloc procedures with utilization of distraction devices has resulted in shortened surgical times, greater facial advancements, and decreased transfusion requirements. The aim of this observational study was to utilize data from the multicenter Pediatric Craniofacial Surgery Perioperative Registry to present and compare patient characteristics and outcomes in children undergoing midface advancement with distraction osteogenesis. ⋯ Monobloc procedures were associated with greater transfusion and longer ICU and hospital length of stay. Perioperative complications were more prevalent in the Monobloc group.
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Paediatric anaesthesia · Apr 2018
Multicenter StudyA psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale.
Emergence delirium and emergence agitation have been a subject of interest since the early 1960s. This behavior has been associated with increased risk of injury in children and dissatisfaction with anesthesia care in their parents. The Pediatric Anesthesia Emergence Delirium Scale is a commonly used instrument for codifying and recording this behavior. ⋯ The one-factor solution and the satisfactory reliability in terms of internal consistency and stability support the use of the Pediatric Anesthesia Emergence Delirium scale for assessing emergence delirium in children recovering from anesthesia after surgery or diagnostic procedures. The kappa statistics for the Pediatric Anesthesia Emergence Delirium scale items essentially indicated good agreement between independent raters, supporting interrater reliability.
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Paediatric anaesthesia · Mar 2018
Multicenter Study Observational StudyPersistent pain following common outpatient surgeries in children: A multicenter study in Italy.
The prevalence of persistent postsurgical pain in children is over 20% after major surgeries; however, data are scarce on the prevalence, character, and risk factors among children undergoing common ambulatory surgeries. The primary aim of this study was to evaluate the prevalence of persistent pain following pediatric ambulatory surgery at 1, 3, and 6 months. Secondary aims were to identify risk factors and characterize the pain and consequences of persistent postsurgical pain. ⋯ Our data support the presence of persistent pain in pediatric patients after common surgeries. Most patients who developed persistent pain at 6 months had pain at 1 month. We recommend questioning at follow-up visit about persistent pain and functional impairment with follow-up until resolution.