Articles: pediatrics.
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Randomized Controlled Trial
Ultrasound-guided scalp nerve block in anesthesia of children receiving cranial suture reconstruction.
Analgesia is very important for children with craniosynostosis who are undergoing cranial suture reconstruction. This study investigated the effectiveness and safety of an analgesic technique based on scalp nerve block combined with general anesthesia versus general anesthesia alone. ⋯ Preoperative scalp nerve block can reduce hemodynamic fluctuation and postoperative pain in children undergoing cranial suture reconstruction for craniosynostosis. Thus, it can be safely and effectively applied in the anesthesia of these children.
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Pediatric emergency care · Jul 2023
Randomized Controlled TrialA Randomized Trial of Incentivization to Maximize Retention for Real-Time Symptom and Activity Monitoring Using Ecological Momentary Assessment in Pediatric Concussion.
The aims of this study were to determine the incentivization strategy that maximizes patient adherence to report symptoms and activity via ecological momentary assessment (EMA) after pediatric concussion, and assess the feasibility of tracking concussed youth using EMA from the emergency department (ED) setting. ⋯ Dynamic incentivization showed higher rates of response to tridaily symptom prompts compared with flat-rate incentivization. These data show tracking concussed youth using EMA from the ED is feasible using a dynamic incentivization strategy, with improved ability to discern outcomes compared with prospective monitoring using follow-up clinical visits.
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Paediatric anaesthesia · Jul 2023
Randomized Controlled Trial Observational StudyComparison of effects of volatile and intravenous anesthetics on pupillary function during general anesthesia in children: A prospective observational study.
The light reflex, which reflects central nervous system dysfunction, can also be affected by anesthetic agents. ⋯ The Neurological Pupil index value in pediatric patients under general anesthesia is affected by the anesthetic agent used; this factor requires consideration in evaluations of the Neurological Pupil index during general anesthesia.
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Randomized Controlled Trial
Health care impact of implementing a clinical pathway for acute care of pediatric concussion: a stepped wedge, cluster randomised trial.
To test the effects of actively implementing a clinical pathway for acute care of pediatric concussion on health care utilization and costs. ⋯ Implementation of a clinical pathway in the ED increased outpatient follow-up and reduced the time from physician initial assessment to disposition, without increasing physician costs. Implementation of a clinical pathway can align acute care of pediatric concussion more closely with existing clinical practice guidelines while making care more efficient.
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Randomized Controlled Trial Multicenter Study
A Complex Intervention to Prevent Medication-Related Hospital Admissions—Results of the Stepped-Wedge Cluster Randomized Trial KiDSafe in Pediatrics.
Children are often treated off-label and are at a disadvantage in pharmacotherapy. The aim of this study was to implement and evaluate a quality assurance measure (PaedPharm) for pediatric pharmacotherapy whose purpose is to reduce medication-related hospitalizations among children and adolescents. ⋯ The introduction of PaedPharm was associated with a decrease in medication-related hospitalizations that did not reach statistical significance. The process evaluation revealed broad acceptance of the intervention in outpatient pediatrics and adolescent medicine.