Paediatric anaesthesia
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Paediatric anaesthesia · May 2012
Review Meta AnalysisCT-guided percutaneous lung biopsy under general anesthesia: a pediatric case series and literature review.
We describe 14 consecutive children who received computed tomography-guided percutaneous lung biopsy (CT-PLB) under general anesthesia over an 18-month period at our institution. Pulmonary hemorrhage (occurring in 36%) and pneumothorax (29%) were the two most common complications; the overall complication rate was 64%. When complications did occur, immediate airway management was facilitated by the presence of an endotracheal tube (ETT). We conclude as follows: (i) CT-PLB in our series is associated with a high risk of both overall and severe complications; (ii) risk of complications is increased by both patient and procedure-related factors; (iii) airway management with ETT may be preferable should a complication arise; (iv) severe complications may necessitate ICU admission, which should be available before proceeding.
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Paediatric anaesthesia · May 2012
Randomized Controlled TrialUltrasound guidance allows faster peripheral IV cannulation in children under 3 years of age with difficult venous access: a prospective randomized study.
Ultrasound-guided peripheral venous access (USG-PIVA) presents many advantages over the reference 'blind' technique in both adults and children in emergency situations. ⋯ Ultrasound-guided peripheral venous access leads to faster peripheral IV access and should therefore be recommended in children presenting with difficult venous access.
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Paediatric anaesthesia · May 2012
Who needs an IV? Retrospective service analysis in a tertiary pediatric hospital.
The question if it is possible and safe to anesthetize children for short procedures without intravenous (IV) access provokes strong opinions among pediatric anesthetists. However, only limited data are available to support either side of the arguments. This pediatric university hospital provides anesthesia to a community dental service, led by staff anesthesiologists. A rapid turnover system based on inhalational induction and maintenance of anesthesia without mandatory IV access has been employed since 2005. ⋯ This service review indicates that general anesthesia for outpatient dental anesthesia may be safely performed without mandatory IV access. The technique employed in this center emphasizes the need for the clinician to primarily concentrate on pediatric airway management in a safe environment with experienced assistance. It supports the hypothesis that instrumentation of the airway (insertion of laryngeal mask airway) can be satisfactorily achieved without prior IV access.