Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2011
Review Meta AnalysisEfficacy and safety of clonidine as additive for caudal regional anesthesia: a quantitative systematic review of randomized controlled trials.
Clonidine is still the most popular additive for caudal regional anesthesia. Aim of the present quantitative systematic review was to assess the efficacy and safety of the combined use of clonidine and local anesthetics in comparison with caudal local anesthetics alone. ⋯ There is considerable evidence that caudally administered clonidine in addition to local anesthetics provides extended duration of analgesia with a decreased incidence for analgesic rescue requirement and little adverse effects compared to caudal local anesthetics alone.
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Paediatric anaesthesia · Dec 2011
Review Meta AnalysisEfficacy and safety of clonidine as additive for caudal regional anesthesia: a quantitative systematic review of randomized controlled trials.
Clonidine is still the most popular additive for caudal regional anesthesia. Aim of the present quantitative systematic review was to assess the efficacy and safety of the combined use of clonidine and local anesthetics in comparison with caudal local anesthetics alone. ⋯ There is considerable evidence that caudally administered clonidine in addition to local anesthetics provides extended duration of analgesia with a decreased incidence for analgesic rescue requirement and little adverse effects compared to caudal local anesthetics alone.
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Paediatric anaesthesia · Dec 2011
ReviewPro con debate: the use of regional vs systemic analgesia for neonatal surgery.
In recent years the inclusion of regional techniques to pediatric anesthesia has transformed practice. Simple procedures such as caudal anesthesia with local anaesthetics can reduce the amounts of general anesthesia required and provide complete analgesia in the postoperative period while avoiding large amounts of opioid analgesia with potential side effects that can impair recovery. ⋯ Currently, opinions are divided and strongly held with some major units adopting this approach widely and others maintaining a more conservative stance to anesthesia for major neonatal surgery. In this pro-con debate the evidence base is examined, supplemented with expert opinion to try to provide a balanced overall view.
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Paediatric anaesthesia · Nov 2011
ReviewAnesthetic management of congenital tracheoesophageal fistula.
This article reviews (a) risk factors and preoperative considerations of the patient with tracheoesophageal fistula, (b) anesthetic management, including (i) airway management, (ii) induction of anesthesia and monitoring and (iii) postoperative disposition, (c) considerations for concomitant congenital heart disease, (d) considerations for thoracoscopic repair and (e) long-term outcomes and considerations of the patient with repaired esophageal atresia/tracheoesophageal fistula.