Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2014
Randomized Controlled TrialAprotinin and transfusion requirements in pediatric craniofacial surgery.
To evaluate transfusion requirements in children receiving aprotinin during craniofacial surgery. ⋯ Aprotinin was associated with decreased packed red blood cell transfusion requirements in children undergoing craniofacial surgery, with no renal toxicity or death. Aprotinin is no longer available for clinical use in the USA because of adverse effects in adults; re-evaluation of aprotinin is warranted for children scheduled to undergo surgery involving potentially high blood loss.
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Paediatric anaesthesia · Feb 2014
Chloral hydrate sedation for magnetic resonance imaging in newborn infants.
The aim of this study was to look for clinically significant adverse effects of chloral hydrate used in a large cohort of infants sedated for magnetic resonance imaging. ⋯ When adhering to strict protocols, MRI scanning in newborn infants in this cohort was performed using chloral hydrate sedation with a relatively low risk of significant adverse effects.
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Paediatric anaesthesia · Feb 2014
Randomized Controlled Trial Comparative StudyChildren's cognitive recovery after day-case general anesthesia: a randomized trial of propofol or isoflurane for dental procedures.
Postoperative cognitive dysfunction (POCD) is well established in adults but has been underinvestigated in children. As day-case procedures are increasingly common, it is important to establish whether children suffer significant POCD. Pediatric POCD has been associated with several intravenous and inhalation anesthetics, but isoflurane has not been studied. As evidence indicates superior recovery after propofol, the study compared POCD after propofol or isoflurane anesthesia. ⋯ Propofol and isoflurane exert similar adverse effects on RT, psychomotor coordination, and visual memory. Selective impairment of verbal recall by propofol is consistent with adult evidence of the drug's effect on retrieval. The enduring postoperative impairment of memory has implications for instructions to parents and caregivers for the safety and well-being of children in the 24 h after day-case anesthesia with propofol and isoflurane.
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Paediatric anaesthesia · Feb 2014
Development and validation of the Pediatric Anesthesia Behavior score - an objective measure of behavior during induction of anesthesia.
Measuring perioperative behavior changes requires validated objective rating scales. We developed a simple score for children's behavior during induction of anesthesia (Pediatric Anesthesia Behavior score) and assessed its reliability, concurrent validity, and predictive validity. ⋯ The PAB score is simple to use and may predict which children are at increased risk of developing postoperative behavioral disturbance. This study provides evidence for its reliability and validity.
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Paediatric anaesthesia · Feb 2014
The use of a double-lumen central venous catheter for airway management in pediatric patients undergoing laryngeal papillomatosis surgery.
To evaluate the efficacy and safety of a spontaneous ventilation anesthesia technique with insufflation of oxygen and volatile agent through a double-lumen central venous catheter (DLCVC) in pediatric patients undergoing suspension laryngoscopic surgery for laryngeal papillomatosis. ⋯ After establishing an adequate depth of anesthesia, a spontaneous ventilation anesthesia technique with insufflation of oxygen and volatile agent through a DLCVC is feasible in pediatric patients undergoing suspension laryngoscopic surgery for laryngeal papillomatosis.