Articles: pediatrics.
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Randomized Controlled Trial Comparative Study
Ultrasound guided quadratus lumborum block versus interlaminar epidural block for analgesia in pediatric abdominal surgery: a randomized controlled trial.
Although the efficacy and safety of epidural block (EB) are fairly high, complications such as inadvertent dural puncture may limit its use. Ultrasound-guided quadratus lumborum block (QLB) is a relatively new regional technique that provides perioperative somatic and visceral analgesia for pediatric patients. This trial compared the quality of pain relief in pediatric patients undergoing abdominal surgery who received either QLB or EB. ⋯ PACTR202203906027106.
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Paediatric anaesthesia · May 2024
Randomized Controlled TrialPerioperative methadone for posterior spinal fusion in adolescents: Results from a double-blind randomized-controlled trial.
Posterior spinal fusion is the most common surgical procedure performed for correction of adolescent idiopathic scoliosis in the United States. Intraoperative methadone has been shown to improve pain control in adult patients undergoing complex spine surgery, and current pediatric studies show encouraging results; however, prospective randomized-controlled trials are lacking in the pediatric literature. ⋯ A two-dose intraoperative methadone regimen resulted in decreased opioid consumption compared to morphine. Although the clinical significance of these results may be limited, the analgesic equipoise without increased opioid-related side effects and potential for a lower incidence of chronic pain may tip the balance in favor of routine methadone use for adolescents undergoing posterior spinal fusion.
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Paediatric anaesthesia · May 2024
Randomized Controlled TrialA randomized, double-blind, dose-controlled study of the use of dexmedetomidine alone for procedural sedation of children and adolescents undergoing MRI scans.
Dexmedetomidine is a selective α2-adrenergic agonist originally approved for sedation of adults in the intensive care unit and subsequently approved for procedural sedation in adults undergoing medical procedures. Dexmedetomidine is widely used off-label for procedural sedation in children. ⋯ Dexmedetomidine was well tolerated. The high dose was associated with meaningfully greater efficacy compared with lower doses. Based on these results, the recommended starting dose for procedural sedation in children ≥1month-<2years is loading dose 1.5 mcg/kg/maintenance infusion 1.5 mcg/kg/h; children ≥2-<17years is loading dose 2.0 mcg/kg/maintenance infusion 1.5 mcg/kg/h.
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J Neurosurg Anesthesiol · Apr 2024
Randomized Controlled TrialUltrasound-guided Greater Occipital Nerve Block in Children Undergoing Posterior Fossa Craniotomy: A Randomized, Controlled Trial.
Posterior fossa surgery is commonly associated with severe postoperative pain. This study assessed the impact of ultrasound-guided greater occipital nerve (GON) block on postoperative pain and hemodynamic profiles in pediatric posterior fossa craniotomy. ⋯ In children undergoing posterior fossa craniotomy, GON block was associated with superior quality and duration of postoperative analgesia and better hemodynamic profile compared with standard care.
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Pediatric emergency care · Apr 2024
Randomized Controlled TrialFeasibility of a Video Otoscope for Diagnosis of Otologic Pathology in the Pediatric Emergency Department.
Performing pediatric otoscopy can be difficult secondary to patient compliance, which potentiates misdiagnosis and inaccurate treatment of acute otitis media. This study used a convenience sample to assess the feasibility of using a video otoscope for the examination of tympanic membranes in children presenting to a pediatric emergency department. ⋯ Caregivers perceive that video otoscopy and standard otoscopy are comparable in comfort, cooperation, examination satisfaction, and diagnosis understanding. Physicians made a wider range of more subtle diagnoses with the video otoscope. However, examination length of time may limit the JEDMED Horus + HD Video Otoscope's feasibility in a busy pediatric emergency department.