Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2007
Randomized Controlled Trial Comparative StudyMultidrug intravenous anesthesia for children undergoing MRI: a comparison with general anesthesia.
We used a multidrug intravenous anesthesia regimen with midazolam, ketamine, and propofol to provide anesthesia for children during magnetic resonance imaging (MRI). This regimen was compared with general anesthesia in a randomized comparative study. Outcome measures were safety, side effects and recovery variables in addition to adverse events in relation to age strata. ⋯ Intravenous midazolam, ketamine and propofol provides safe and adequate anesthesia, comparable with that obtained from general endotracheal anesthesia, for most children during MRI.
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Paediatric anaesthesia · Dec 2007
Randomized Controlled Trial Comparative StudyThe optimum initial pediatric epidural bolus: a comparison of four local anesthetic solutions.
There is no consensus on the concentration or type of local anesthetic used for initiation of epidural anesthesia. The aim of this randomized, double-blind, controlled trial was to compare the clinical effectiveness of epidural administration of both levobupivacaine and bupivacaine in 0.2% and 0.25% concentrations in pediatric patients undergoing abdominal and urological surgery. ⋯ While there is no difference in the proportion of effective surgical anesthesia, the lower incidence of pain and distress with the 0.25% solutions suggests that this concentration has clinical advantages over the 0.2% solutions for pediatric epidural anesthesia.
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Paediatric anaesthesia · Dec 2007
Clinical validation of the Multidimensional Assessment of Pain Scale.
The Multidimensional Assessment Pain Scale (MAPS), was developed to measure postoperative pain in critically ill preverbal children. Following preliminary psychometric testing, additional validation of this 5-category 10-point scale was required. This article reports the results of a follow-up validation study that aimed to evaluate the clinical validity and utility of the MAPS. ⋯ This study showed that 'MAPS like FLACC and VASobs decreases similarly following rescue morphine. MAPS-revised can be recommended for clinical application.
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Paediatric anaesthesia · Dec 2007
Clinical TrialStudy of the adjustment of the Ambu laryngeal mask under magnetic resonance imaging.
Our aim in this study was to analyze the adjustment of the laryngeal mask, Ambu AuraOnce, in pediatric patients during magnetic resonance imaging (MRI) and to look for a correlation between clinical parameters such as the sealing pressure and the ease of introduction with radiological parameters. ⋯ The Ambu AuraOnce can be regarded as a safe product for airway maintenance in pediatric patients. No relationship was found between radiological measurements and sealing pressures.
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Paediatric anaesthesia · Dec 2007
Case ReportsRectus sheath block: successful use in the chronic pain management of pediatric abdominal wall pain.
Seven pediatric patients (aged 11-16 years) with chronic abdominal wall pain are presented who gained significant relief from a rectus sheath block (RSB). We describe the case histories and review the relevant literature for this technique. The etiology of the abdominal wall pain was considered to be abdominal cutaneous nerve entrapment, iatrogenic peripheral nerve injury, myofascial pain syndrome or was unknown. ⋯ In the majority of cases, the procedure was carried out under general anesthesia as a daycase procedure. Local anesthetic and steroids were used. This is the first report of the successful use of this technique in the chronic pain management setting in children.