Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2008
Perioperative thromboprophylaxis in children: development of a guideline for management.
Venous thromboembolic (VTE) events can occur in children at the time of surgery where a patient has associated prothrombotic risk factors. There is currently little advice available to anesthetists on how to assess the risks and provide prophylaxis. ⋯ Children with multiple risk factors for VTE should be considered for prophylactic measures when presenting for prolonged major surgery.
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Paediatric anaesthesia · Jun 2008
A national survey of propofol infusion use by paediatric anaesthetists in Great Britain and Ireland.
Since the introduction of propofol in 1977, it has been widely used for the induction and maintenance of anaesthesia and for sedation on the intensive care unit. Recently, case reports of suspected propofol infusion syndrome (PRIS) following short term infusions have been published. We set out to obtain a picture of the current use of propofol infusions by paediatric anaesthetists in Great Britain and Ireland. ⋯ There is a wide variety in the use of propofol infusions by paediatric anaesthetists. The mechanisms underlying PRIS are poorly understood and require further work to ensure propofol infusions are used appropriately for anaesthesia in children.
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Paediatric anaesthesia · Jun 2008
Case ReportsLidocaine 5% patch for localized chronic neuropathic pain in adolescents: report of five cases.
We describe a case series of five adolescents who were managed with lidocaine 5% patches for chronic localized neuropathic pain from a variety of causes with minimal adverse effects. Treatment was effective in four of five patients with only one patient complaining of minimal pain relief. 5% Lidocaine patches have been used for treatment of chronic neuropathic pain in adults and we have found this to be effective in management of localized neuropathic pain in children and adolescents.
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Paediatric anaesthesia · Jun 2008
Experience with remifentanil-sevoflurane balanced anesthesia for abdominal surgery in neonates and children less than 2 years.
Few data report remifentanil use in the neonatal population. We described here our experience with remifentanil-sevoflurane balanced anesthesia in neonates and children less than 2 years who underwent general anesthesia for abdominal surgery. ⋯ Remifentanil-sevoflurane anesthesia can be used for general anesthesia in neonates. We observed that anesthetists used lower doses of remifantanil and lower concentrations of sevoflurane in neonates compared with the older children.
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Paediatric anaesthesia · Jun 2008
Effects of head posture on the oral, pharyngeal and laryngeal axis alignment in infants and young children by magnetic resonance imaging.
Objective anatomical studies supporting the different recommendations for laryngoscopy in infants and young children are scarce. The objective of this study was to measure by magnetic resonance imaging (MRI) the consequences of head extension on the oral, pharyngeal and laryngeal axes in infants and young children. ⋯ In infants and young children, under general anesthesia and with a laryngeal mask airway in place, just a slight head extension improves alignment of the line of vision of the glottis and the laryngeal axis (narrowing of angle delta) but worsened the alignment of the pharyngeal and laryngeal axes (widening of angle beta).