Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2016
ReviewAn institutional approach to the management of the 'Can't Intubate, Can't Oxygenate' emergency in children.
The 'Can't Intubate Can't Oxygenate' emergency is rare in children. Nevertheless, airway clinicians involved in pediatric airway management must be able to rescue the airway percutaneously through the front of the neck should this situation be encountered. Little evidence exists in children to guide rescue techniques, and extrapolation of adult evidence may be problematic due to anatomical differences. This document reviews the currently available evidence, and presents a practical approach to standardizing equipment, techniques, and training for managing the 'Can't Intubate Can't Oxygenate' emergency in children.
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Paediatric anaesthesia · Jul 2016
ReviewThe cost effectiveness of transesophageal echocardiography for pediatric cardiac surgery: a systematic review.
Intraoperative transesophageal echocardiography (ITEE) for pediatric cardiac surgery has been described as clinically efficacious and cost-effective. There are a small number of publications supporting these claims. ⋯ ITEE for pediatric cardiac surgery is effective and cost-saving. This is a validation of the current practice patterns. These finding may influence the expansion of the use of this technology.
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Paediatric anaesthesia · Jul 2016
ReviewThe cost effectiveness of transesophageal echocardiography for pediatric cardiac surgery: a systematic review.
Intraoperative transesophageal echocardiography (ITEE) for pediatric cardiac surgery has been described as clinically efficacious and cost-effective. There are a small number of publications supporting these claims. ⋯ ITEE for pediatric cardiac surgery is effective and cost-saving. This is a validation of the current practice patterns. These finding may influence the expansion of the use of this technology.
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This educational review explores the current understanding of accidental awareness during general anesthesia (AAGA) in children. Estimates of incidence in children vary between 1 in 135 (determined by direct questioning) and 1 in 51,500 (determined from spontaneous reporting). ⋯ The value of depth of anesthesia monitoring in preventing AAGA is uncertain but is probably useful in patients having total intravenous anesthesia and NMB. Reports of AAGA by children should be received sympathetically and a generic protocol for managing distressed patients is presented.
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Paediatric anaesthesia · Apr 2016
Review Meta AnalysisRectus sheath and transversus abdominis plane blocks in children: a systematic review and meta-analysis of randomized trials.
The role of rectus sheath blocks (RSB) and transversus abdominis plane (TAP) blocks in pediatric surgery has not been well established. ⋯ Abdominal wall blocks reduce pain and opiate use in children. We advise cautious interpretation of the results given the heterogeneity of studies.