Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2024
The accuracy of the ultrasound measured transverse cricoid diameter and the epiphyseal transverse diameter of the distal radius in predicting the pediatric endotracheal tube size.
In everyday pediatric anesthesia practice, clinicians frequently exchange an already inserted endotracheal tube because of a leak or resistance causing significant morbidity. We investigated the accuracy of two ultrasound measurements; the transverse cricoid diameter and epiphyseal diameter of the distal radius in the prediction of endotracheal tube size that best fits in children compared to age-based formulas. ⋯ Both transverse cricoid diameter and epiphyseal diameter of the distal radius are reliable predictors of the size of best-fit-ETT pediatric endotracheal tube compared to age-based formulas. To save time and effort, we recommend the US measurement of the epiphyseal diameter of distal radius in the preoperative visit and documenting the predicted tube size with the preoperative assessments.
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Paediatric anaesthesia · Jan 2024
ReviewAnalysis of the factors contributing to residual weakness after sugammadex administration in pediatric patients under 2 years of age.
Sugammadex reverses the neuromuscular blockade induced by rocuronium and vecuronium and is approved by the U.S. Food and Drug Administration for use in patients aged over 2 years. There is, however, a paucity of data regarding its dosing profile in infants and children younger than 2 years. ⋯ In this single-center, retrospective cohort study of pediatric surgery patients, there was an association between the hazard of sugammadex redose with both increased age and weight.
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Paediatric anaesthesia · Jan 2024
Randomized Controlled TrialUltrasound-guided selective supraclavicular nerve block for postoperative pain control in children receiving Hickman catheter or chemoport insertion: A randomized controlled trial.
Optimal pain management after insertion of a central venous catheter in children remains unclear. ⋯ Ultrasound-guided SSCNB is an effective method for managing postoperative pain in children undergoing Hickman catheter or chemoport insertion, reducing the need for analgesics within 24 h after surgery.
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Paediatric anaesthesia · Jan 2024
Multicenter Study Observational StudyRegistries in pediatric anesthesiology: A brief history and a new way forward.
Clinical registries are multicenter prospective observational datasets that have been used to examine current perioperative practices in pediatric anesthesia. These datasets have proven useful in quantifying the incidence of rare adverse outcomes. Data from registries can highlight associations between severe patient safety events and patient and procedure-related risk factors. ⋯ The maintenance of registries over time can be challenging due to difficulties in modifying the included variables, collaborator fatigue, and continued outlay of resources to maintain the database and onboard new sites. These latter issues can lead to decreased data quality. In this article, we discuss key insights from several pediatric anesthesia registries and propose a new type of registry that addresses some shortcomings of the current paradigm.