Paediatric anaesthesia
-
The erector spinae plane block (ESPB) is perhaps one of the most interesting of the tissue plane blocks described recently. There has been an exponential increase in the number of publications for both adults and children over the past 5 years. ⋯ Anatomical differences in children, particularly in neonates and infants, may explain the spread in this age group. In most pediatric studies, erector spinae plane block was opioid sparing, and noninferiority was observed when compared with other regional techniques.
-
Paediatric anaesthesia · Mar 2024
Anesthesia and intensive care unit care in pediatric kidney transplantation: An international survey.
Despite the high perioperative risk profile, international guidelines for anesthesia and intensive care unit (ICU) care in pediatric kidney transplantation do not exist. Optimizing hemodynamics can be challenging in these patients, while scientific data to guide decisions in hemodynamic monitoring, hemodynamic targets, and perioperative fluid management are lacking. The limited annual number of pediatric kidney transplantations, even in reference centers, necessitates the urge for international collaboration to share knowledge and develop research and guidelines. The aim of this study was to collect data on current perioperative anesthesia and ICU care practices in pediatric kidney transplantation. ⋯ The results of this survey reveal a large variation in anesthesia and ICU care in pediatric kidney transplantation centers worldwide, particularly in CVP and CO targets, hemodynamic therapy, and the use of furosemide and mannitol. These data identify areas for further research and can be a starting point for international research collaboration and guideline development.
-
Paediatric anaesthesia · Mar 2024
Observational StudyImmediate postdelivery airway management of neonates with prenatally diagnosed micrognathia: A retrospective observational study.
Micrognathic neonates are at risk for upper airway obstruction, and many require intubation in the delivery room. Ex-utero intrapartum treatment is one technique for managing airway obstruction but poses substantial maternal risks. Procedure requiring a second team in the operating room is an alternative approach to secure the obstructed airway while minimizing maternal risk. The aim of this study was to describe the patient characteristics, airway management, and outcomes for micrognathic neonates and their mothers undergoing a procedure requiring a second team in the operating room at a single quaternary care children's hospital. ⋯ Though shown to be safe and effective, more data are needed to support the use of procedure requiring a second team in the operating room as an alternative to ex-utero intrapartum treatment for micrognathia outside of highly specialized maternal-fetal centers.