Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2009
Long-term posttraumatic effects of intraoperative awareness in children.
The consequences of intraoperative awareness in children have received little empirical attention to date. Previous studies suggest that children are less likely to be distressed than adults in the short term, but long-term consequences have only been studied retrospectively. ⋯ Although no children had clinically significant symptoms, the small numbers and failure to follow-up all children limit any conclusions with respect to true incidence of posttraumatic stress disorder in children who have had an awareness event.
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Paediatric anaesthesia · Dec 2009
Anesthesia for children with hyperleukocytosis a retrospective review.
Hyperleukocytosis (a white cell count in peripheral blood >100 x 10(9) l(-1)) is a well-recognized medical emergency. Rates of morbidity associated with anesthesia in hyperleukocytotic patients have not been previously described. This retrospective study describes the perioperative morbidity and mortality of children who present acutely with hyperleukocytosis. ⋯ Children with leukemia-related hyperleukocytosis often require general anesthesia at the time of presentation and are at significant perioperative risk. Respiratory adverse events are very common and mandate close postanesthesia care.
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Paediatric anaesthesia · Dec 2009
An acute pain service improves postoperative pain management for children undergoing selective dorsal rhizotomy.
A continuous epidural infusion of morphine is the pain treatment modality for children undergoing selective dorsal rhizotomy (SDR) in our institution. The aim of the study was to evaluate the impact of having an organized acute pain service (APS) on postoperative pain management of these children. ⋯ Although we recognize that it is possible that there were changes in care not related specifically to the introduction of a dedicated APS that occurred in our institution that resulted in improvements in general postoperative care and in length of stay, our study did show that having an organized APS allowed to significantly decrease the incidence of postoperative oxygen desaturation and to decrease the hospital length of stay by 1 day.