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 AnalysisPediatric video laryngoscope versus direct laryngoscope: a meta-analysis of randomized controlled trials.
Video-laryngoscopy in pediatric anesthesia improves glottis visualization but prolongs intubation time and increases failure.
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Paediatric anaesthesia · Oct 2014
Review Meta Analysis Comparative StudyControlled ventilation or spontaneous respiration in anesthesia for tracheobronchial foreign body removal: a meta-analysis.
Either controlled ventilation or spontaneous respiration is commonly used in general anesthesia for inhaled foreign body removal via rigid bronchoscopy. Controversy in the literature exists concerning which form of ventilation is optimally suited for bronchoscopy. We performed a meta-analysis to compare controlled ventilation and spontaneous respiration with respect to complications, operation time, and anesthesia recovery time. ⋯ Current evidence does not show a preference for either controlled ventilation or spontaneous respiration, although laryngospasm has a lower incidence when controlled ventilation is performed. Additional clinical studies are required to substantiate this issue.
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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