PubMed Journal Database | Paediatric anaesthesia - Page: 4 
The US National Library of Medicine and National Institutes of Health manage PubMed.gov which comprises of more than 21 million records, papers, reports for biomedical literature, including MEDLINE, life science and medical journals, articles, reviews, reports and books. BioPortfolio aims to publish relevant information on published papers, clinical trials and news associated with users selected topics.
For example view all recent relevant publications on Epigenetics and associated publications and clincial trials.
Showing PubMed Articles 76–100 of 142 from Paediatric anaesthesia
Background: This crossover study compared fiber-optic assessment of laryngeal mask airway (LMA) position in children using two LMA insertion techniques, i.e., standard and rotational. Methods: Seventy-eight ASA I children, aged 2.5 months to 10 years, undergoing elective cataract surgery were included in this study. LMA was inserted in random order using either standard or rotational technique, removed, and thereafter crossed over to alternate technique. Positioning of LMA was assessed using fiber...
History of pediatric regional anesthesia.
The history of local and regional anesthesia began with the discovery of the local anesthetic properties of cocaine in 1884. Shortly afterwards nerve blocks were being attempted for surgical anesthesia. Bier introduced spinal anesthesia in 1898, two of his first six patients being children. Spinal anesthesia became more widely used with the advent of better local anesthetics, stovaine and procaine in 1904-1905. Caudals and epidurals came into use in children much later. In the early years these blocks were...
Objective/Aims: To assess current practices in the management of children undergoing craniofacial surgery and identify areas of significant practice variability with the intent to direct future research. Background: The perioperative management of infants and children undergoing craniofacial reconstruction surgery can be challenging because of the routine occurrence of significant blood loss with associated morbidity. A variety of techniques have been described to improve the care for these children....
Postoperative hyponatremia following calvarial vault remodeling in craniosynostosis.
Background: The incidence, severity, and risk factors for the development of hyponatremia in patients undergoing craniosynostosis surgery are not well known. Objective: To determine the incidence and severity of hyponatremia as a complication in surgical correction of craniosynostosis and to identify risk factors for postoperative hyponatremia. Methods: A retrospective medical record review for 2003-2008 of the Cleft and Craniofacial Database was made. Specific data collected included sodium values...
Background: The anesthetic risks and outcomes of the first 100 consecutive spring-assisted surgeries (SAS) for cranial expansion from a single institution are reported. The effect of number of procedures was also tested on hematocrit postoperative day 1 (POD1), anesthesia time, and surgery time of the first procedure. Methods: The records of 100 consecutive patients undergoing SAS were reviewed. Anesthesia management and related complications are presented. Time series linear regression analysis was p...
Pediatric sedation - evolution and revolution.
Pediatric sedation continues to change in terms of the professionals who provide this care, those who produce original research on this topic, guidelines and literature concerning risk, medications employed, and methods for training for new providers. Some of the changes could be categorized as 'evolutionary' or gradual in nature and predictable - such as the changing role of anesthesiologists in the field of pediatric sedation and the use of the well-established dissociative sedative, ketamine. Other chang...
Objective: To evaluate the effect of ketamine, as an adjunct to fentanyl, on postoperative analgesia and duration of Postoperative Care Unit (PACU) stay, in children undergoing tonsillectomy. Background: Ketamine, as an N-methyl-d-aspartate antagonist, has been recognized to have an opioid sparing effect. In addition, it does not depress respiration or affect airway tone. Hence, addition of ketamine could be potentially beneficial in children undergoing tonsillectomy, due to the high incidence of slee...
Stratification of sedation risk - a challenge to the sedation continuum.
We detail the limitations of the current paradigm of the sedation continuum - a tool ubiquitous to all sedation care settings and now a quarter century old. Definitions in this existing taxonomy are based on patient responsiveness to verbal and/or tactile stimuli, and the inherent subjectivity of this focus has both challenged the reliable assessment of adverse event risk and precluded clear delineation of sedation boundaries, e.g., what is the dividing line between moderate and deep sedation? We present th...
The effect of dexmedetomidine during myringotomy and pressure-equalizing tube placement in children.
Background: Bilateral myringotomy (BMT) is a commonly performed otolaryngologic procedure in children. Objectives: To examine the effects of intranasal dexmedetomidine, an α(2) -adrenoceptor agonist, on time-averaged pain scores, pain control, need for rescue analgesia, and agitation scores in children undergoing BMT. Methods: We designed a trial to enroll 160 children randomized to one of four groups: two study groups, dexmedetomidine (1 or 2 μg·kg(-1) ), or two control groups representing ou...
Children on phenobarbital monotherapy requires more sedatives during MRI.
Background: Phenobarbital induces specific hepatic cytochrome P-450 enzyme pathways causing increased clearance of hepatically metabolized drugs. In this study, we investigated the duration and additional anesthetic requirement during Magnetic resonance imaging (MRI) in epileptic children with or without phenobarbital monotherapy. Methods: In ASA I-II, 128 children, aged 1-10 years, were included. Group I: epileptic children without anti-epileptic therapy and Group II: children with phenobarbital mo...
Background: Neonates have a higher metabolic rate and an increased risk of perioperative hypoglycemia and lipolysis, but during anesthesia, both oxygen consumption and metabolic rate are decreased, and this may lead to reduced intraoperative glucose requirements. Objective: The objective of this prospective multicentre observational postauthorisation safety study was to evaluate the intraoperative use of a novel isotonic balanced electrolyte solution with a low glucose concentration of 1% (BS-G1) in n...
Objectives/Aim: To determine whether sedation/analgesia drugs used before, during, and after infant cardiac surgery are associated with neurodevelopmental outcome. Background: Animal models suggest detrimental effects of anesthetic drugs on the developing brain. Whether these results can be extrapolated to human neonates is unclear. Methods/Materials: This is a prospective follow-up project conducted in Western Canada. In all infants ≤6 weeks of age having surgery for congenital heart disease b...
Are you hungry? Are you thirsty? - fasting times in elective outpatient pediatric patients.
Objective: This study assessed the duration of pre-operative fasting in children and its impact on the subjective feeling of hunger and thirst prior to elective outpatient anesthesia. Background: Pediatric fasting guidelines are designed to reduce the risk of pulmonary aspiration of gastric contents during general anesthesia, and a fasting regimen of 6-8 h for solids, 4 h for breast milk, and 2 h for clear fluids is commonly used. Anecdotal evidence suggests that fasting times are often excessiv...
Anesthesia and neurotoxicity to the developing brain: the clinical relevance.
Laboratory work has confirmed that general anesthetics cause increased neuronal apoptosis and changes to the morphology of dendritic spines in the developing brains of animals. It is an effect seen with most volatile anesthetics as well as with ketamine and propofol. The effects are dose dependent and seen over particular periods of early development. There is some evidence that rodents exposed to anesthesia during infancy have delayed neurobehavioral development. There are inherent limitations in translati...
Anesthetizing the obese child.
The prevalence of childhood obesity is increasing. The focus of this review is the special anesthetic considerations regarding the perioperative management of obese children. With obesity the risk of comorbidity such as asthma, obstructive sleep apnea, hypertension, and diabetes increases. The obese child has an increased risk of perioperative complications especially related to airway management and ventilation. There is a significantly increased risk of difficult mask ventilation and perioperative desatur...
Cerebral oximetry for pediatric anesthesia: why do intelligent clinicians disagree?
Reflectance near-infrared spectroscopy has been used to measure cortical tissue oximetry for more than 30 years. In that time, many centers have adopted the routine use of the cerebral oximeter for children having repair of congenital heart lesions, while some prominent academic centers have resisted routine use of these monitors citing lack of definitive evidence for outcome benefit. In this review, we provide an overview of the method used to measure cerebral oximetry, as well as validation and clinical...
Transition from pediatric to adult health services: the perioperative care perspective.
Increasing numbers of children with congenital and chronic diseases are surviving beyond adolescence. Consequently, arrangements must be put in place to ensure that these groups of patients continue to receive high-quality care into adulthood. Although some medical disciplines have reacted positively to this growing challenge, perioperative care has lagged behind. This review explores some of the difficulties in delivering optimal perioperative care in the transitional period. Key issues, including the pauc...
Aim: To investigate the effect of fasting times for clear fluids and solids/non-clear fluids on gastric content volume using magnetic resonance imaging (MRI). Methods: Pediatric patients undergoing diagnostic MRI under deep propofol sedation, with the stomach located within the area of diagnostic study, were included in this clinical observational study. According to standard institutional guidelines, children were allowed to eat/drink until 4 h and to drink clear fluids until 2 h before scheduled...
Background: Supraglottic high-frequency jet ventilation (HFJV) in laryngotracheal surgery in infants with modified jet laryngoscopes offers the surgeon an unimpaired operating field. However, supraglottic HFJV is associated with the development of high airway pressures, inadvertent positive end-expiratory pressure (PEEP) levels, and barotrauma. Methods: We investigated the total lung volumes (TLV) and tidal volume variations at peak inspiratory pressure levels (PIP) and at PEEP levels along with the p...
Background: During the induction of anesthesia, changes in functional residual capacity and ventilation distribution (VD) occur. Although these physiological changes are well investigated in adults, little data are available in infants and children. Aim: To describe continuous changes in lung physiology during the induction of anesthesia in infants and children using electrical impedance tomography (EIT). Methods: Lung mechanics and volume changes in 38 infants and children undergoing elective card...
Perioperative management of pediatric patients on mechanical cardiac support.
The population of children with end-stage heart failure requiring mechanical circulatory support is growing. These children present for diagnostic imaging studies, various interventions and noncardiac surgical procedures that require anesthetic care. This article is a review of the population demographics of children on mechanical cardiac support, the alternative devices available, and the important concepts for safe perioperative management of these patients. The discussion will be limited to devices for s...
Background: Placement of sciatic catheters with ultrasound and stimulating catheters is known. Literature regarding catheter placements with only ultrasound is limited. We aimed to investigate the feasibility of performing continuous sciatic nerve block exclusively with ultrasound guidance and minimal equipment. Method: Forty ASA 1 and 2 patients aged 8 months-10 years posted for congenital talipoequinovarus surgery were included in the study. Continuous sciatic catheters were placed under ultraso...
Defining awakening from anesthesia in neonates: a consensus study.
Background: A descriptive tool for determining awakening in infants is desirable to test the value of depth of anesthesia monitors. Although scales and criteria have been developed for children and infants, none has been applied to the study of anesthetised neonates. We aimed to seek consensus in a group of experts on a definition of awakening at the end of anesthesia in neonates. Methods: We used a modified Delphi technique with an iterative process of questionnaires and anonymised feedback. Communic...
Objectives: A descriptive tool or validated scale of consciousness is desirable in infants to test the value of any depth of anesthesia monitor. Methods: We have reviewed published descriptions and scales of observed behavior that may be applicable to the study of infants during the transition from anesthesia to wakefulness. Results: Potentially useful scales were found that had been developed for the assessment and study of natural sleep, neurological state, arousal, anesthesia, sedation, coma, an...
An audit of laryngoscopes and application of a new ISO standard.
Objective: The International Organization for Standardization (ISO) recently published an International Standard (ISO 7376:2009) which specifies illuminance levels and tests for illumination from hook-on type laryngoscopes used for intubation. A clinical study examining luminance for laryngoscopy found that 100 cd·m(-2) was the minimum level acceptable for laryngoscopy. The purpose of this study was to measure the quality of light from laryngoscopes available for use by anesthetists in an anesthetic d...
