Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2010
Randomized Controlled TrialEfficacy of bupivacaine-neostigmine and bupivacaine-tramadol in caudal block in pediatric inguinal herniorrhaphy.
Limited duration of analgesia is among the limitations of single caudal injection with local anesthetics. Therefore, the purpose of this study was to evaluate the effectiveness and safety of bupivacaine in combination with either neostigmine or tramadol for caudal block in children undergoing inguinal herniorrhaphy. ⋯ In conclusion, tramadol (1 mg x kg(-1)) compared with neostigmine (2 microg x kg(-1)) might provide both prolonged duration of analgesia and extended time to first analgesic in caudal block.
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Paediatric anaesthesia · Sep 2010
Impact of chronic condition status and severity on dental treatment under general anesthesia for Medicaid-enrolled children in Iowa state.
To assess the impact of chronic condition (CC) status and CC severity, respectively, on the odds of receiving dental treatment under general anesthesia (GA) for Medicaid-enrolled children by age group. ⋯ Chronic condition status and severity were more important determinants of dental treatment under GA for Medicaid-enrolled children ages 6-14 than for those <6. Understanding these relationships is a critical step in developing clinical strategies and interventions aimed at preventing dental disease for Medicaid-enrolled children whose reasons for needing dental treatment under GA are modifiable.
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Paediatric anaesthesia · Sep 2010
Incidence of sore throat in children following use of flexible laryngeal mask airways - impact of an introducer device.
Insertion of a flexible laryngeal mask airway (FLMA) is more difficult and therefore might result in a higher risk for trauma to the upper airway. To facilitate the insertion of FLMA, the use of an introducer device (Portex Limited, Hythe, Kent, UK) was promoted. However, the impact of the use of this device on the occurrence of postoperative sore throat is unknown. ⋯ In this study with controlled low cuff pressures, the incidence of sore throat was low. The use of an introducer device did not affect the rate of sore throat.
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Paediatric anaesthesia · Sep 2010
Perioperative care of patients with epidermolysis bullosa: proceedings of the 5th international symposium on epidermolysis bullosa, Santiago Chile, December 4-6, 2008.
Epidermolysis bullosa (EB) has become recognized as a multisystem disorder that poses a number of pre-, intra-, and postoperative challenges. While anesthesiologists have long appreciated the potential difficult intubation in patients with EB, other systems can be affected by this disorder. Hematologic, cardiac, skeletal, gastrointestinal, nutritional, and metabolic deficiencies are foci of preoperative medical care, in addition to the airway concerns. ⋯ A multinational, interdisciplinary panel of experts assembled in Santiagio, Chile to review the best practices for perioperative care of patients with EB. This paper presents guidelines that represent a synthesis of evidence-based approaches and the expert consensus of this panel and are intended to aid physicians new to caring for patients with EB when operative management is indicated. With proper medical optimization and attention to detail in the operating room, patients with EB can have an uneventful perioperative course.