Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2009
Randomized Controlled TrialClowns for the prevention of preoperative anxiety in children: a randomized controlled trial.
To determine if specially trained professional clowns allayed preoperative anxiety and resulted in a smooth anesthetic induction compared to the use of midazolam or no intervention. ⋯ This study found that the use of preoperative medically trained clowns for children undergoing surgery can significantly alleviate preoperative anxiety. However, clowns do not have any effect once the anesthesia mask is introduced.
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Paediatric anaesthesia · Mar 2009
ReviewAnesthetic considerations for major burn injury in pediatric patients.
Major burn injury remains a significant cause of morbidity and mortality in pediatric patients. With advances in burn care and with the development of experienced multi-disciplinary teams at regionalized burn centers, many children are surviving severe burn injury. ⋯ These children provide several anesthetic challenges, such as difficult airways, difficult vascular access, fluid and electrolyte imbalances, altered temperature regulation, sepsis, cardiovascular instability, and increased requirements of muscle relaxants and opioids. The anesthesia provider must understand the physiologic derangements that occur with severe burn injury as well as the subsequent anesthetic implications.
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Paediatric anaesthesia · Mar 2009
Randomized Controlled TrialPropofol for tracheal intubation in children anesthetized with sevoflurane: a dose-response study.
Tracheal intubation during sevoflurane induction is frequently facilitated with i.v. propofol. We designed a dose-response study to evaluate the intubating conditions, and the incidence and duration of apnea after i.v. propofol in children. ⋯ During sevoflurane/nitrous oxide anesthesia, propofol 3 mg x kg(-1) provides superior intubating conditions with an increased incidence of and prolonged apnea compared with 0 and 0.5 mg x kg(-1).
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Paediatric anaesthesia · Mar 2009
Incidence and risk factors for preincision hypotension in a noncardiac pediatric surgical population.
Routine monitoring of blood pressure is an essential part of perioperative care in adults and children. It is however not known whether intraoperative hypotension (IOH) is clinically important in the 'healthy' pediatric patient. This may be partly due to the lack of data on the incidence and consequences of IOH in this group of patients. We utilized the Brain Trauma Foundation definition of hypotension to describe the incidence of preincision hypotension (PIH) in a large pediatric noncardiac surgical population and identified risk factors for the occurrence PIH. ⋯ Preincision hypotension is common in the pediatric surgical population undergoing general anesthesia. Factors independently predictive of PIH included high ASA status, pre-existing hypotension, propofol co-induction prolonged preincision period and adolescent age group. The importance of blood pressure monitoring, prompt recognition of hypotension and use of appropriate intervention is emphasized.