Anaesthesia
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Observational Study
The safety of paediatric surgery between COVID-19 surges: an observational study.
Despite the ongoing coronavirus disease 2019 (COVID-19) pandemic, elective paediatric surgery must continue safely through the first, second and subsequent waves of disease. This study presents outcome data from a children's hospital in north-west England, the region with the highest prevalence of COVID-19 in England. Children and young people undergoing elective surgery isolated within their household for 14 days, then presented for real-time reverse transcriptase polymerase chain reaction testing for severe acute respiratory syndrome coronavirus disease-2 (SARS-CoV-2) within 72 h of their procedure (or rapid testing within 24 h in high-risk cases), and completed a screening questionnaire on admission. ⋯ However, the current cohort were younger (p = 0.037); of increased complexity (p < 0.001) and underwent more complex surgery (p < 0.001). The combined use of household self-isolation, testing and screening questionnaires has allowed the re-initiation of elective paediatric surgery at high volume while maintaining pre-COVID-19 outcomes in children and young people undergoing surgery. This may provide a model for addressing the ongoing challenges posed by COVID-19, as well as future pandemics.
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For routine anaesthesia in ASA 1 & 2 patients a 6.0-7.0 mm ETT is probably the best balance between ventilation needs and airway trauma.
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Randomized Controlled Trial
The effect of dexmedetomidine on postoperative behaviour change in children: a randomised controlled trial.
Dexmedetomidine does not improve day 3 behaviour among 2-7 year olds after day case surgery.
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Randomized Controlled Trial
A randomised controlled trial of fibrinogen concentrate during scoliosis surgery.
Bleeding and blood transfusion are common after scoliosis surgery. Fibrinogen is essential for blood clot formation and depletes quickly during haemorrhage. ⋯ Seven and four children received allogeneic red blood cell transfusion after fibrinogen and placebo, respectively, p = 0.34. There were no side-effects.
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Multicenter Study
Risks to healthcare workers following tracheal intubation of patients with COVID-19: a prospective international multicentre cohort study.
Within 30 days of their first COVID intubation, 10% of anaesthetists reported positive COVID infection.
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