Anesthesiology clinics
-
Anesthesiology clinics · Jun 2009
ReviewUltrasound guidance for pediatric peripheral nerve blockade.
There is an increasing trend in the use of peripheral nerve blockade for postoperative analgesia in children, and the use of ultrasound guidance to perform peripheral nerve blocks is gaining popularity. A thorough knowledge of anatomy will help in performing the appropriate block, and will also aid in better use and understanding of ultrasound guidance. In this article, we briefly review the use of ultrasound guidance to perform common upper and lower extremity and truncal blocks.
-
Although certain data suggest that common general anesthetics may be neurotoxic to immature animals, there are also data suggesting that these same anesthetics may be neuroprotective against hypoxicischemic injury, and that inadequate analgesia during painful procedures may lead to increased neuronal cell death in animals and long-term behavioral changes in humans. The challenge for the pediatric anesthesia community is to design and implement studies in human infants to ascertain the safety of general anesthesia. In this article, the authors review the relevant preclinical and clinical data that are currently available on this topic.
-
Hemoglobinopathies are diseases involving abnormalities of the structure or production of hemoglobin. Examples include sickle cell disease, the thalassemias, and rare hemoglobin variants producing cyanosis. ⋯ Hemoglobinopathies may present to the anesthesiologist as the primary cause of a surgical procedure, as an incidental complicating factor of a surgical patient, or with a problem arising from the disease itself. This article reviews the common types of hemoglobinopathies, presents a basic summary of the pathophysiology relevant to anesthesia, and outlines current perioperative management.
-
The accurate assessment and effective treatment of acute pain in children in the hospital setting is a high priority. During the past 2 to 3 decades, pediatric pain management has gained tremendous knowledge with respect to the understanding of developmental neurobiology, developmental pharmacology the use of analgesics in children, the use of regional techniques in children, and of the psychological needs of children in pain. A wide range of medications is available to treat a variety of pain types. This article provides an overview of the most common analgesic medications and techniques used to treat acute pain in children.