Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2010
Randomized Controlled Trial Comparative StudyA randomized trial of propofol consumption and recovery profile with BIS-guided anesthesia compared to standard practice in children.
To evaluate the impact of bispectral index (BIS) monitoring on the consumption of propofol and recovery from anesthesia compared to the standard clinical practice in children. ⋯ Our study showed no benefit of BIS-guided propofol administration on anesthetic consumption or recovery compared to standard anesthetic practice.
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Paediatric anaesthesia · Feb 2010
Comparative Study Clinical TrialComparing peripheral venous access between obese and normal weight children.
Intravenous (i.v.) access is sometimes a difficult, time-consuming, and highly frustrating procedure. Obesity is widely believed to be associated with difficult peripheral intravenous access (PIV) placement. This study examined the relationship between body mass index (BMI) and ease of venous access in children undergoing noncardiac surgical procedures. ⋯ These data indicate that i.v. placement is more difficult in obese children than their lean peers and that the most likely site for successful placement in obese children after a failed attempt on the dorsum of the hand is the volar surface of the hand. Knowledge of potential sites for successful i.v. access could help to improve the success rate for i.v. placement.
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Paediatric anaesthesia · Feb 2010
Multicenter StudySemi-elective intraosseous infusion after failed intravenous access in pediatric anesthesia.
Intraosseous (IO) infusion is a well-established intervention to obtain vascular access in pediatric emergency medicine but is rarely used in routine pediatric anesthesia. ⋯ IO access represents a quick and reliable alternative for pediatric patients with prolonged difficult or failed IV access after inhalational induction of anesthesia.
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Paediatric anaesthesia · Feb 2010
Nurse-controlled analgesia (NCA) following major surgery in 10,000 patients in a children's hospital.
Patients who received NCA with morphine following major surgery between 1996 and 2008 at Great Ormond Street Hospital, London, UK, were prospectively studied in the postoperative period to determine effectiveness, morphine requirements, incidence of common side effects, and serious adverse events. ⋯ NCA with morphine is an acceptable, safe, and effective method of postoperative analgesia for a wide range of ages and types of surgery in our practice. Morphine requirements increase with age, but there was also considerable inter-individual variation within age groups. PONV, itching, sedation, and respiratory depression are expected side effects. SAE are uncommon but the incidence is greatest in neonates.