Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2014
Review Meta AnalysisAnalgesic effect and adverse events of dexmedetomidine as additive for pediatric caudal anesthesia: a meta-analysis.
Dexmedetomidine has become a popular additive for regional anesthesia. Aim of this meta-analysis was to assess the effect of this additive on the duration of postoperative analgesia and possible adverse events in pediatrics undergoing orchidopexy or lower abdominal surgery. ⋯ Dexmedetomidine as an additive to local anesthetic provides a significantly longer postoperative analgesia with comparable adverse effects and hemodynamic changes, when compared to local anesthetics alone. There were insufficient data of the effects of different concentrations of dexmedetomidine; further studies are required to explore this issue.
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Paediatric anaesthesia · Nov 2014
ReviewAnesthetic agents in patients with very long-chain acyl-coenzyme A dehydrogenase deficiency: a literature review.
Very long-chain acyl-coenzyme A dehydrongenase deficiency (VLCADD) is a rare disorder of fatty acid metabolism that renders sufferers susceptible to hypoglycemia, liver failure, cardiomyopathy, and rhabdomyolysis. The literature about the management of these patients is hugely conflicting, suggesting that both propofol and volatile anesthesia should be avoided. We have reviewed the literature and have concluded that the source papers do not support the statements that volatile anesthetic agents are unsafe. ⋯ It is therefore not recommended. Suxamethonium-induced myalgia may mimic symptoms of rhabdomyolysis and cause raised CK therefore should be avoided. Opioids, NSAIDS, regional anesthesia, and local anesthetic techniques have all been used without complication.
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Paediatric anaesthesia · Oct 2014
Review Meta AnalysisSupraglottic airway devices vs tracheal intubation in children: a quantitative meta-analysis of respiratory complications.
In the absence of airway infection, the use of a laryngeal mask airway in children is associated with fewer postop complications than intubation.
pearl -
Paediatric anaesthesia · Oct 2014
Review Meta AnalysisEvaluation of i-gel(™) airway in children: a meta-analysis.
I-gel(™) is a relatively newer addition in the pediatric anesthesia practice. Its comparison with the other laryngeal mask airway repor-ted a wide range of results. Randomized controlled trials where i-gel(™) has been compared with other laryngeal masks (laryngeal mask airway ProSeal(™) and laryngeal mask airway Classic(™) ) in children for airway management device during general anesthesia has been included in this meta-analysis. ⋯ We conclude that i-gel(™) is an effective alternative of the commonly used laryngeal mask airway ProSeal(™) and laryngeal mask airway Classic(™) in children for airway management during general anesthesia.