Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2010
Comment Letter Case ReportsReply to 'Successful resuscitation of bupivacaine-induced cardiotoxicity in a neonate'.
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Paediatric anaesthesia · Nov 2010
Randomized Controlled Trial Comparative StudyImproved analgesia with the ilioinguinal block compared to the transversus abdominis plane block after pediatric inguinal surgery: a prospective randomized trial.
Ultrasound-guided transversus abdominis plane (TAP) block has shown promise for analgesia after pediatric inguinal surgery. This prospective, randomized study tested the hypothesis that the TAP block would provide comparable analgesia after pediatric inguinal surgery compared with a conventional ultrasound-guided ilioinguinal block. ⋯ Following pediatric inguinal surgery, ilioinguinal block provides more effective analgesia than the TAP block.
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Paediatric anaesthesia · Nov 2010
Cannot ventilate-cannot intubate an infant: surgical tracheotomy or transtracheal cannula?
An unanticipated difficult airway is very uncommon in infants. The recommendations for managing the cannot ventilate-cannot intubate (CVCI) situation in infants and small children are based on difficult airway algorithms for adults. These algorithms usually recommend placement of a transtracheal cannula or performing a surgical tracheotomy as a last resort. In this study, we compared the success rate and time used for inserting a transtracheal cannula vs performing a modified surgical tracheotomy in a piglet model. ⋯ We found placement of a transtracheal cannula to be significantly less successful than the modified surgical tracheotomy in a piglet model. We question whether placement of a transtracheal cannula should be recommended in infants in a cannot ventilate-cannot intubate situation.
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Paediatric anaesthesia · Nov 2010
Randomized Controlled Trial Comparative StudyTwo-agent analgesia versus acetaminophen in children having bilateral myringotomies and tubes surgery.
The objective of this study was to determine whether the incidence of emergence agitation (EA) can be reduced by adding an additional, faster onset, non-IV analgesic, intranasal fentanyl or intramuscular (im) ketorolac to rectal acetaminophen. ⋯ We conclude that two-agent analgesia is not superior to acetaminophen alone for decreasing the incidence of EA after inhalation anesthesia with sevoflurane for BM&T surgery. Our overall incidence of EA was low compared to previous studies, which could potentially have decreased our ability to detect differences between groups.
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Paediatric anaesthesia · Nov 2010
Randomized Controlled TrialSlower administration of propofol preserves adequate respiration in children.
Propofol is a versatile anesthetic agent used in pediatric practice to facilitate investigational and interventional procedures. Propofol can cause significant respiratory depression, the management of which may require advanced airway management skills. This investigation aimed to increase the safety of propofol administration by developing a dosing schedule that would preserve spontaneous respiration in at least 95% of subjects. ⋯ The respiratory response to propofol is highly variable in children. Slower infusion of propofol will result in a lower risk of respiratory depression.