Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2006
Randomized Controlled Trial Comparative StudyThe efficacy of morphine and Entonox analgesia during chest drain removal in children.
Morphine is commonly used for chest drain removal pain, although a few studies in adults suggest that inhalation agents may be effective for this procedure. Little is known about chest drain removal pain and its management in children. ⋯ Morphine or Entonox alone are unlikely to provide adequate analgesia for chest drain removal pain in children. More research is needed to determine the most effective interventions for this procedure.
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Paediatric anaesthesia · Mar 2006
Randomized Controlled TrialThe efficacy of caudal morphine or bupivacaine combined with general anesthesia on postoperative pain and neuroendocrine stress response in children.
The aim of this study was to compare the effectiveness of caudal morphine and bupivacaine usage on surgical stress response in children undergoing abdominal and genitourinary surgery while keeping anesthesia depth constant utilizing the bispectral index analysis (BIS). ⋯ We conclude that, caudal administration of bupivacaine is more effective than morphine for attenuating intraoperative and postoperative stress response to surgery in children.
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Paediatric anaesthesia · Mar 2006
The revised FLACC observational pain tool: improved reliability and validity for pain assessment in children with cognitive impairment.
Difficulty with pain assessment in individuals who cannot self-report their pain poses a significant barrier to effective pain management. However, available assessment tools lack consistent reliability as pain measures in children with cognitive impairment (CI). This study evaluated the validity and reliability of the revised and individualized Face Legs Activity Cry and Consolability (FLACC) behavioral pain assessment tool in children with CI. ⋯ Findings support the reliability and validity of the FLACC as a measure of pain in children with CI.
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Paediatric anaesthesia · Mar 2006
Case ReportsUse of dexmedetomidine in awake craniotomy in adolescents: report of two cases.
Awake craniotomy is a key tool in resection of lesions near critical functional regions, particularly the speech area. Craniotomy with an awake portion for mapping may be performed in carefully selected adolescents and preteenaged children. A number of different regimens may be used for sedation and anesthesia in these cases. We describe two adolescent patients in whom awake craniotomy was performed using an intravenous anesthesia technique with dexmedetomidine and without need for airway instrumentation.
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Paediatric anaesthesia · Mar 2006
Case ReportsExperience with gabapentin for neuropathic pain in adolescents: report of five cases.
Summary Gabapentin is an antiepileptic drug indicated for the treatment of partial seizures in children. Many studies have proved its analgesic action in the treatment of neuropathic pain in adults and we have noticed an analgesic action of gabapentin in neuropathic pain in children. Five patients treated in the Children's Hospital Pain Control Service for intractable neuropathic pain were included in gabapentin treatment. ⋯ We noticed a rapid improvement, in 1 week, of our patients' VAS scores (from 9 or 10 to 4 or 3) with minimal adverse effects. In the follow-up period of 6 months we gradually reduced the dose of gabapentin. Our findings are that gabapentin should be included earlier in the treatment of neuropathic pain in adolescents, because it rapidly improves analgesia and has minimal side effects.