Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2005
Caudal injectate can be reliably imaged using portable ultrasound--a preliminary study.
Correct caudal cannula placement is essential for block success and the avoidance of complications. The aim of this study was to assess the use of a saline injection test bolus with ultrasound (US) imaging to identify correct cannula placement for caudal anesthesia. ⋯ These preliminary results suggest saline test bolus under US imaging is a reliable indicator of correct cannula position for caudal block. We found it safe, quick to perform, and provided additional useful information.
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Paediatric anaesthesia · Nov 2005
Clinical TrialPreliminary experience with oral dexmedetomidine for procedural and anesthetic premedication.
Oral premedication is often required in children to provide anxiolysis and lessen the psychological impact of hospitalization and/or procedures. We present our experience with dexmedetomidine as an oral premedicant prior to procedural sedation or anesthetic induction. ⋯ These preliminary data suggest that dexmedetomidine may be an effective oral premedicant prior to anesthesia induction or procedural sedation. We found that it was effective even in patients with neurobehavioral disorders in whom previous attempts at sedation had failed.
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Paediatric anaesthesia · Nov 2005
Case ReportsNeonatal pneumothorax--an unexpected perioperative complication.
We report our experience of three cases of intraoperative pneumothorax in neonatal surgical patients. Following a review of the literature, we discuss possible causes for each case and methods of treatment. We emphasize the need for inclusion of pneumothorax as a cause for cardiorespiratory instability even when no predisposition is identifiable and highlight the need for prompt treatment to prevent serious morbidity and mortality.
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Paediatric anaesthesia · Nov 2005
Case ReportsRemifentanil for sedation and analgesia in a preterm neonate with respiratory distress syndrome.
We present the efficacy and safety of the use of remifentanil for intubation, sedation and analgesia in a preterm infant during mechanical ventilation for respiratory distress syndrome. A 34-week-old baby, born by cesarean delivery that developed respiratory distress, required intubation and ventilatory support. For intubation, the baby was given midazolam (0.2 mg.kg(-1)) and remifentanil (1 microg.kg(-1)). ⋯ The remifentanil infusion was then discontinued and 30 min later the baby was awake and extubated with success. There were no side effects after intubation or during the continuous infusion. The profile of remifentanil allowing a rapid recovery, the absence of side effects and a good level of sedation and analgesia support the choice of this opioid for sedation in the NICU.
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Paediatric anaesthesia · Nov 2005
Pain management in the neonatal intensive care unit: a national survey in Italy.
This study assessed current medical practice in preventative analgesia and sedation for invasive procedures in neonatal intensive care units (NICU) in Italy. ⋯ The need for adequate analgesia is still underestimated. Further information on the safety of analgesics in neonatology is imperative, as is an adequate education of physicians and nurses on the use of pain control guidelines as part of the standard of care in the NICU.