Paediatric anaesthesia
-
Paediatric anaesthesia · Apr 2012
Randomized Controlled TrialAudiovisual aid viewing immediately before pediatric induction moderates the accompanying parents' anxiety.
Parents accompanying their child during induction of anesthesia experience stress. The impact of audiovisual aid (AVA) on parental state anxiety and assessment of the child's anxiety at induction have been studied previously but need closer scrutiny. ⋯ Preoperative AVA shown to parents immediately before induction moderates the increase in anxiety associated with the anesthetic induction of their child. Present results suggest that behavioral characteristics seem better predictors of child's anxiety during induction than anxiety ratings per se and that anesthetists are better than parents in predicting child's anxiety during induction.
-
Paediatric anaesthesia · Apr 2012
Does topical lidocaine before tracheal intubation attenuate airway responses in children? An observational audit.
The use of topical lidocaine, applied to the airways with various administration techniques, is common practice in pediatric anesthesia in many institutions. However, it remains unclear whether these practices achieve their intended goal of reducing the risk of perioperative respiratory adverse events (PRAE) in children undergoing elective endotracheal intubation without neuromuscular blockade (NMB). The relative frequency of PRAE (laryngospasm, coughing, desaturation <95%) associated with no use of topical airway lidocaine (TAL), with TAL sprayed directly onto the vocal cords, and TAL administered blindly into the pharynx was assessed. ⋯ The incidence of desaturation was higher in patients receiving TAL compared with children who did not. This association should perhaps be considered when contemplating the use of this technique.
-
Paediatric anaesthesia · Apr 2012
Comparative StudyA comparison of inhalational inductions for children in the operating room vs the induction room.
There has been debate about the use of an induction room (IR) compared with an operating room (OR) for inhalational induction in children. The quality of the anesthesia induction between these two physical environments has not been studied previously. We sought to compare child distress, OR utilization and efficiency, and parental satisfaction and safety, between an IR and an OR. ⋯ We found no differences in child distress, parent satisfaction, and respiratory complications between inductions conducted in the IR vs the OR. Differences in utilization, efficiency, and turnover were minimal and not operationally significant. Capital equipment, space, and staffing strategies should be key drivers in considerations for the use of IRs, and in the design of ORs with IRs.
-
Paediatric anaesthesia · Apr 2012
Strengthening handover communication in pediatric cardiac intensive care.
To evaluate knowledge transfer and perceptions using a structured handover process for the postoperative pediatric cardiac patient being admitted to intensive care. The hypothesis being that knowledge transfer could be optimized by the implementation of this handover structure. ⋯ Communication between the operating room and intensive care staff, regarding postoperative pediatric cardiac patients, significantly improved with the implementation of a structured handover.