Paediatric anaesthesia
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Paediatric anaesthesia · May 2005
Clinical TrialVentilation with the laryngeal tube in pediatric patients undergoing elective ambulatory surgery.
The laryngeal tube is a new supraglottic alternative for securing the airway. Few data on the use of this airway device in pediatric patients are so far available. Experiences of the study are reported. ⋯ In the age group studied, the laryngeal tube provides a rapid, patent airway in the majority of patients with a low complication rate.
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Paediatric anaesthesia · May 2005
Case ReportsUltrasound assessment of caudal catheter position in infants.
The positioning of caudally inserted epidural catheters is crucial to their effectiveness. However, level assessment can be difficult and time consuming. We report the use of ultrasound to assess the catheter position in three patients aged between 1 and 10 months. The advantages and disadvantages of this technique are discussed in relation to other methods of assessing caudal catheter placement.
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Paediatric anaesthesia · May 2005
Clinical assessment of the laryngeal tube in pediatric anesthesia.
The aim of this study was to evaluate a new device for airway management in children: the laryngeal tube (LT). ⋯ The LT is not recommended for children <10 kg. Over 10 kg, it provides a clear airway in most children, with a low rate of minimal additional maneuvers for sizes 2 and 3. The failure rate also decreases with the operator's training.
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Paediatric anaesthesia · May 2005
The use of physical restraints on paediatric intensive care units.
Physical restraints are used in critical care units in an attempt to reduce the risk of treatment interference. Their use remains controversial and there are concerns regarding the effectiveness and safety of restraint techniques. There are few data available on the prevalence of physical restraint use in Paediatric Intensive Care Units (PICU) in the UK and we have therefore conducted a cross-sectional survey to define current clinical practice. ⋯ Physical restraint is a commonly used technique on PICU in the UK. There is considerable variation in clinical practice and current clinical guidelines which are available do not deal specifically with children. Prospective randomized trials would be necessary to fully investigate the role of physical restraints amongst critically ill children.
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Paediatric anaesthesia · May 2005
Anatomical considerations of the pediatric ilioinguinal/iliohypogastric nerve block.
The ilioinguinal/iliohypogastric nerve block is safe, effective and easy to perform in order to provide analgesia for a variety of inguinal surgical procedures in pediatric patients. A relatively high failure rate of 10-25% has been reported, even in experienced hands. The aim of this study was to determine the exact anatomical position of the ilioinguinal and iliohypogastric nerves in relation to an easily identifiable constant bony landmark, the anterior superior iliac spine (ASIS) in neonates and infants. The current ilioinguinal/iliohypogastric nerve block techniques were also evaluated from an anatomical perspective. ⋯ We suggest that the high failure rate of the ilioinguinal/iliohypogastric nerve block in this age group could be due to lack of specific spatial knowledge of the anatomy of these nerves in infants and neonates. This cadaver-based study suggests an insertion point closer to the ASIS, approximately 2.5 mm (range: 1.0-4.9) from the ASIS on a line drawn between the ipsilateral ASIS and the umbilicus.