Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2009
Impact of normal saline infusion on postoperative metabolic acidosis.
Standard base excess (SBE) is an important parameter for guiding fluid management in postoperative metabolic acidosis. However, individual SBE components, notably the chloride effect (Cl(eff)), provide valuable additional information. Cl(eff) is the deviation of the strong ion difference (SID) from normal caused by chloride loss or increase and represents the effect on SBE of an abnormal chloride-sodium ratio. Many centers use normal saline (NS) for intravascular volume therapy. In this study, we examined the impact of NS infusion on SBE and its chloride-driven component (Cl(eff)) in postoperative children. ⋯ Implementing serial Cl(eff) assessment could improve postoperative management by disclosing or excluding hyperchloremia as a cause of acidosis undetectable from SBE alone. Calculating the chloride-driven acidifying side effect of NS infusion using Cl(eff) improves the interpretation of SBE values and can optimize fluid management in postoperative metabolic acidosis.
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Paediatric anaesthesia · Nov 2009
Randomized Controlled TrialAcupuncture management of pain and emergence agitation in children after bilateral myringotomy and tympanostomy tube insertion.
To further investigate the effect of acupuncture in postoperative pain and emergence agitation in children undergoing bilateral myringotomy and tympanostomy tube (BMT) placement. ⋯ Our study suggests that acupuncture therapy may be effective in diminishing both pain and emergence agitation in children after BMT insertion without adverse effects.