Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2009
Randomized Controlled Trial Comparative StudyA comparison of the STORZ video laryngoscope and standard direct laryngoscopy for intubation in the Pediatric airway--a randomized clinical trial.
Direct laryngoscopy can be challenging in infants and neonates. Even with an optimal line of sight to the glottic opening, the viewing angle has been measured at 15 degrees . The STORZ DCI video laryngoscope (Karl Storz, Tuttlingen, Germany) incorporates a fiberoptic camera in the light source of a standard laryngoscope of variable sizes. The image is displayed on a screen with a viewing angle of 80 degrees . We studied the effectiveness of the STORZ DCI as an airway tool compared to standard direct laryngoscopy in children with normal airway. ⋯ This study demonstrates that the STORZ DCI video laryngoscope provides an improved view to the glottis in children with normal airway anatomy, but requires a longer time for intubation.
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Paediatric anaesthesia · Nov 2009
Randomized Controlled TrialEpinephrine test dose in children: is it interpretable on ECG monitor?
Epidural and other regional blocks are performed in children under general anesthesia; the response to a 'test dose' may be altered during administration of general anesthetics. Limited data is available describing changes in electrocardiogram, blood pressure and heart rate (HR) following unintentional intravascular injection of a lidocaine-epinephrine-containing test dose, under sevoflurane anesthesia in children. ⋯ An increase in T-wave amplitude can easily be detected by carefully observing the ECG monitor or an ECG printout within a minute following the accidental i.v. administration of 0.1 ml x kg(-1) of 1% lidocaine-epinephrine (0.5 microg x kg(-1)) regional anesthetic test dose in children under sevoflurane anesthesia.
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Paediatric anaesthesia · Nov 2009
Randomized Controlled Trial Comparative StudyComparison of the Cobalt Glidescope video laryngoscope with conventional laryngoscopy in simulated normal and difficult infant airways.
To evaluate the new pediatric Glidescope (Cobalt GVL Stat) by assessing the time taken to tracheal intubation under normal and difficult intubation conditions. We hypothesized that the Glidescope would perform as well as conventional laryngoscopy. ⋯ The new Glidescope performs as well as the Miller laryngoscope under simulated normal and difficult airway conditions.
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Paediatric anaesthesia · Nov 2009
Salbutamol premedication in children with a recent respiratory tract infection.
Premedication with beta-2 agonists (e.g. salbutamol) is effective in preventing increases in total respiratory resistance and in decreasing the incidence of perioperative bronchospasm in asthmatic children. Because children with recent respiratory tract infection (RTI) exhibit bronchial hyperreactivity similar to that observed in asthmatic children, the use of salbutamol in children with RTI has become popular among pediatric anesthetists for the prevention of perioperative respiratory adverse events (PRAE). In a prospective observational study, we therefore assessed the usefulness of salbutamol premedication on the occurrence of PRAE. ⋯ The results from this audit suggest that children with a history of a recent RTI have significantly less PRAE following a premedication with salbutamol compared with no premedication. Therefore, premedication with salbutamol might be considered in children with recent RTI.
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Paediatric anaesthesia · Nov 2009
Parent-assisted or nurse-assisted epidural analgesia: is this feasible in pediatric patients?
The aim of this study was to assess the feasibility of parent-assisted or nurse-assisted epidural analgesia (PNEA) for control of postoperative pain in a pediatric surgical population. ⋯ Parent-assisted or nurse-assisted epidural analgesia can be safely administered to children undergoing surgery who are physically or cognitively unable or unwilling to self-activate a demand dose. Additional studies are needed to compare the efficacy of PNEA with other modalities for postoperative pain control in children.