Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2007
Ambulatory anesthesia and the lack of consensus among Canadian pediatric anesthesiologists: a survey.
The purpose of this study was to assess the current selection criteria for outpatient surgery in children among Canadian pediatric anesthesiologists. ⋯ Further studies are needed to establish evidence-based medicine to support guidelines that would allow one to select children safely for ambulatory surgery.
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Paediatric anaesthesia · Mar 2007
The relationship between bispectral index and endtidal concentration of sevoflurane during anesthesia and recovery in spontaneously ventilating children.
Global inverse correlation between BIS (bispectral index) and depth of anesthesia using sevoflurane has been documented in children in several studies under experimental conditions and in steady-state conditions during mechanically controlled ventilation. Because sevoflurane mask anesthesia combined with a peripheral nerve block is widely used in children, we studied the relationship between BIS and endtidal concentration of sevoflurane (PE(sevo)) under these conditions during surgery and emergence. ⋯ Caution is required for intraoperative titration based on BIS when spontaneous ventilation is maintained because of the wide variability compared with PE(sevo). During emergence using FAW, BIS varied significantly less than PE(sevo), but the clinical relevance of this point could be discussed during anesthesia without tracheal intubation.
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Paediatric anaesthesia · Mar 2007
RSI in pediatric anesthesia - is it used by nonpediatric anesthetists? A survey from south-west England.
Rapid sequence induction (RSI) is the 'gold standard' technique for preventing aspiration of gastric contents during induction of anesthesia in unfasted patients. We conducted a survey to discover whether the conduct of RSI in children varies amongst anesthetists and if practice alters in relation to the time since training or degree of ongoing experience. ⋯ Classical RSI is used for children by most anesthetists in south-west England. RSI is modified for infants especially by more recently trained consultants. Suxamethonium is used less by consultant anesthetists. Whilst RSI is performed for appendicectomy there is a large variation in techniques for anesthetizing children for MUA and scrotal exploration which is independent of the grade of anesthetist.
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Paediatric anaesthesia · Mar 2007
Randomized Controlled Trial Comparative StudySteal-induction after clonidine premedication: a comparison of the oral and nasal route.
Clonidine premedication in children reliably provides preoperative sedation and anxiolysis, but onset of oral clonidine is known to be slow. Nasal clonidine has been shown to reach peak plasma levels within 10 min in rodents. The aim of the present study was to compare clinical effects and percentage of steal-induction after clonidine premedication by the oral and nasal route. ⋯ Intranasal clonidine administration has no advantage over the oral route. Clinical effects were similar with both routes; there was a trend towards a faster onset of sedation with oral clonidine. Clonidine premedication causes light sleep, which allows a steal-induction in 60% of patients.