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Paediatric Anaesthesia

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https://www.readbyqxmd.com/read/28436074/an-evaluation-of-the-mixed-pediatric-unit-for-blood-loss-replacement-in-pediatric-craniofacial-surgery
#1
Stefan Mogensen, Norbert Lubenow, Pelle Nilsson, Henrik Engquist, Folke Knutsson, Per Enblad, Daniel Nowinski, Peter Frykholm
BACKGROUND: Surgical correction for craniosynostosis is often associated with significant perioperative hemorrhage. We implemented a transfusion strategy with a strict protocol including transfusion triggers, frequent assessment of coagulation tests, and the use of a novel transfusion unit, the mixed pediatric unit. AIM: The aim of the study was to evaluate if the applied transfusion strategy could reduce total blood loss and number of blood donors. METHODS: Children <1 year old admitted for craniosynostosis surgery were included for the study...
April 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28419679/assessing-the-survival-impact-of-perioperative-opioid-consumption-in-children-and-adolescents-undergoing-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#2
Pascal Owusu-Agyemang, Andrea Hayes-Jordan, Antoinette Van Meter, Uduak U Williams, Acsa M Zavala, Ravish Kapoor, Shannon M Popovich, Elizabeth Rebello, Lei Feng, Juan P Cata
BACKGROUND: Several studies in adult patients have suggested an unfavorable association between opioid consumption and cancer progression. AIMS: This study investigated the impact of opioid consumption on the survival of children and adolescents undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. METHODS: A retrospective study of patients <19 years who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was performed...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28419660/acute-masseter-dystonia-in-a-pediatric-patient-receiving-aripiprazole-and-methylphenidate-following-induction-of-general-anesthesia
#3
Michelle LeRiger, Jasper Williams, Greta Duncan-Wiebe, Mohanad Shukry
An 11-year-old male receiving aripiprazole, methylphenidate, and clonidine developed acute masseter dystonia inhibiting tracheal intubation after induction of general anesthesia with propofol and rocuronium. Following emergence, he had trismus and jaw discomfort. Psychiatry consultation suspected an acute dystonic reaction, so diphenhydramine was administered intravenously which resolved symptoms. We suspect chronic aripiprazole and methylphenidate usage combined with propofol administration in the short-term absence of methylphenidate made this patient susceptible to dystonic reactions...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28419639/differences-in-intraoperative-hemodynamics-between-spinal-and-general-anesthesia-in-infants-undergoing-pyloromyotomy
#4
Caleb Ing, Lena S Sun, Alexander F Friend, Minjae Kim, Mitchell F Berman, William Paganelli, Guohua Li, Robert K Williams
BACKGROUND: Hypotension and bradycardia are known side effects of spinal anesthesia in pregnant women undergoing cesarean section and adults undergoing other surgical procedures. Whether children experience similar hemodynamic changes is unclear. AIMS: The purpose of this study is to evaluate hemodynamic effects of spinal anesthesia compared to general anesthesia in a cohort of healthy infants. METHODS: The University of Vermont Medical Center almost exclusively used spinal anesthesia for infant pyloromyotomy surgery between 2008 and 2013, while Columbia University Medical Center relied on general anesthesia...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28419616/the-provision-of-pediatric-cardiac-anesthesia-services-in-germany-current-status-of-structural-and-personnel-organization
#5
Torsten Baehner, Oliver Dewald, Ingo Heinze, Matthias Mueller, Ehrenfried Schindler, Uwe Schirmer, Georg Baumgarten, Andreas Hoeft, Richard K Ellerkmann
BACKGROUND: Anesthesia for pediatric cardiac surgery requires a high level of expert knowledge. There are currently no recommendations and standards for anesthetic management for congenital cardiac surgery in Germany. AIM: The aim of the present study was to assess the current status of structural and personnel anesthetic standards at pediatric cardiac surgery centers in Germany. METHOD: All cardiac surgical centers in Germany were reviewed for an active program for congenital heart surgery...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28414899/comparison-of-sedation-by-intranasal-dexmedetomidine-and-oral-chloral-hydrate-for-pediatric-ophthalmic-examination
#6
Qianzhong Cao, Yiquan Lin, Zhubin Xie, Weihua Shen, Ying Chen, Xiaoliang Gan, Yizhi Liu
BACKGROUND AND AIM: Pediatric ophthalmic examinations can be conducted under sedation either by chloral hydrate or by dexmedetomidine. The objective was to compare the success rates and quality of ophthalmic examination of children sedated by intranasal dexmedetomidine vs oral chloral hydrate. METHODS: One hundred and forty-one children aged from 3 to 36 months (5-15 kg) scheduled to ophthalmic examinations were randomly sedated by either intranasal dexmedetomidine (2 μg·kg(-1) , n = 71) or oral chloral hydrate (80 mg·kg(-1) , n = 70)...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28393462/current-use-of-factor-concentrates-in-pediatric-cardiac-anesthesia
#7
REVIEW
Nina A Guzzetta, Glyn D Williams
Excessive bleeding following pediatric cardiopulmonary bypass is associated with increased morbidity and mortality, both from the effects of hemorrhage and the therapies employed to achieve hemostasis. Neonates and infants are especially at risk because their coagulation systems are immature, surgeries are often complex, and cardiopulmonary bypass technologies are inappropriately matched to patient size and physiology. Consequently, these young children receive substantial amounts of adult-derived blood products to restore adequate hemostasis...
April 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28393433/nasal-high-flow-oxygen-delivery-in-children-with-abnormal-airways
#8
Susan Humphreys, Derek Rosen, Tessa Housden, Julia Taylor, Andreas Schibler
BACKGROUND: Transnasal Humidified Rapid-Insufflation Ventilatory Exchange has been shown to safely prolong the safe apnea time in well children post induction of anesthesia and is rapidly becoming a new standard for apneic oxygenation in adults. The same oxygenation technique is described as nasal high flow and can be used in infants and children at risk of apnea during anesthesia. AIM: We investigated the use of nasal high flow oxygen delivery during anesthesia in children with abnormal airways requiring tubeless airway assessment or surgery...
April 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28393428/interactive-web-based-format-vs-conventional-brochure-material-for-information-transfer-to-children-and-parents-a-randomized-controlled-trial-regarding-preoperative-information
#9
Gunilla Lööf, Cecilia Liljeberg, Staffan Eksborg, Per-Arne Lönnqvist
BACKGROUND: Information transfer to patients is an integral part of modern medicine. Internet-based alternatives represent a new and attractive way for information transfer. METHODS: The study used a prospective observer-blinded design. Children (3-12 years) and parents were instructed to get further preoperative information either through an interactive web-based platform, the Anaesthesia-Web, or conventional brochure material until day of outpatient surgery. On the day of surgery, children and parents were separately asked six different questions...
April 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28370856/validation-of-adapted-dartmouth-operative-conditions-scale-for-sedation-during-pediatric-esophagogastroduodenoscopy
#10
Vanmathi Chandran, Barath Jagadisan, Barani Ganth
AIMS: Pediatric esophagogastroduodenoscopy requires deep sedation as it involves stimulation of the airway. Frequency of adverse events is higher with esophagogastroduodenoscopy. Hence, monitoring needs sedation scales like the Dartmouth Operative Condition Scale that identifies safe states of sedation. This study aims at validating the Adapted Dartmouth Operative Condition Scale for sedation rating by pediatricians during pediatric esophagogastroduodenoscopy. METHODS: Items in the Dartmouth Operating Conditions Scale were adapted for pediatric esophagogastroduodenoscopy...
April 3, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28370691/anatomical-description-of-the-sciatic-nerve-block-at-the-subgluteal-region-in-a-neonatal-cadaver-population
#11
Adrienne A Acar, Adrian T Bösenberg, Albert-Neels van Schoor
INTRODUCTION: Sciatic nerve blocks provide intraoperative and prolonged postoperative pain management after lower limb surgery (posterior knee, foot, skin graft surgery). Accurate needle placement requires sound anatomical knowledge. Anatomical studies on children are uncommon; most have been performed on adult cadavers. We studied the location of the sciatic nerve at the gluteal level in neonatal cadavers to establish useful anatomical landmarks. METHODS: We identified the sciatic nerve in the gluteal and thigh region of 20 neonatal cadavers...
April 3, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28370645/outcomes-of-a-failure-mode-and-effects-analysis-for-medication-errors-in-pediatric-anesthesia
#12
Lizabeth D Martin, Eliot B Grigg, Shilpa Verma, Gregory J Latham, Sally E Rampersad, Lynn D Martin
The Institute of Medicine has called for development of strategies to prevent medication errors, which are one important cause of preventable harm. Although the field of anesthesiology is considered a leader in patient safety, recent data suggest high medication error rates in anesthesia practice. Unfortunately, few error prevention strategies for anesthesia providers have been implemented. Using Toyota Production System quality improvement methodology, a multidisciplinary team observed 133 h of medication practice in the operating room at a tertiary care freestanding children's hospital...
March 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28345802/the-association-between-caudal-anesthesia-and-increased-risk-of-postoperative-surgical-complications-in-boys-undergoing-hypospadias-repair
#13
Brad M Taicher, Jonathan C Routh, John B Eck, Sherry S Ross, John S Wiener, Allison K Ross
INTRODUCTION: Recent reports have suggested that caudal anesthesia may be associated with an increased risk of postoperative surgical complications. We examined our experience with caudal anesthesia in hypospadias repair to evaluate for increased risk of urethrocutaneous fistula or glanular dehiscence. METHODS: All hypospadias repairs performed by a single surgeon in 2001-2014 were reviewed. Staged or revision surgeries were excluded. Patient age, weight, hypospadias severity, surgery duration, month and year of surgery, caudal anesthesia use, and postoperative complications were recorded...
March 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28345782/red-cell-distribution-width-as-a-novel-predictor-of-postoperative-respiratory-adverse-events-after-adenotonsillectomy
#14
Betul Kozanhan, Mehmet S Iyisoy
BACKGROUND: Respiratory adverse events are commonly observed after adenotonsillectomy in children with sleep-disordered breathing. Preoperative prediction of these events enhances quality of care and resource management in facilities while encouraging precautions against them. Red cell distribution width, a measure of erythrocyte size variability, has recently been linked to adverse outcomes in a variety of disorders. Red cell distribution width has also been found to be associated with severity of obstructive sleep apnea in adults due to hypoxia-mediated inflammation...
March 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28332251/measuring-the-depth-of-the-caudal-epidural-space-to-prevent-dural-sac-puncture-during-caudal-block-in-children
#15
Hyun Jeong Lee, Ji Young Min, Hyun Il Kim, Hyo-Jin Byon
BACKGROUND: Caudal blocks are performed through the sacral hiatus in order to provide pain control in children undergoing lower abdominal surgery. During the block, it is important to avoid advancing the needle beyond the sacrococcygeal ligament too much to prevent unintended dural puncture. This study used demographic data to establish simple guidelines for predicting a safe needle depth in the caudal epidural space in children. METHODS: A total of 141 children under 12 years old who had undergone lumbar-sacral magnetic resonance imaging were included...
March 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28332249/fifty-years-of-the-american-academy-of-pediatrics-section-on-anesthesiology-a-history-of-our-specialty
#16
Rita Agarwal, Jennifer Riefe, Constance S Houck
The American Academy of Pediatrics Section on Anesthesiology and Pain Medicine celebrated its 50th Anniversary in 2015. The Section was one of the first and only subspecialty organizations in anesthesiology at the time. This special article will focus on the contributions of the Section to the practice of pediatric anesthesiology in the areas of advocacy, education and member contributions. In 1986, the Section created the Robert M. Smith Award to honor those members who had made significant advances in the practice of pediatric anesthesiology...
March 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28321993/metatropic-dysplasia-a-skeletal-dysplasia-with-challenging-airway-and-other-anesthetic-concerns
#17
Mary C Theroux, Martha Lopez, Patricia J Olszewsky, Sabina DiCindio, Lynda Arai, Colleen Ditro, Michael B Bober, Olubukola Opeyemi Olla, Tetsu Uejima, David W West, William G Mackenzie
BACKGROUND: Metatropic dysplasia is a rare form of skeletal dysplasia requiring multiple anesthetics for surgical and imaging procedures, most of which are orthopedic procedures. We provide centralized care to patients with skeletal dysplasia at our tertiary care pediatric hospital, and we were able to collect the largest number of metatropic dysplasia patients reported to date. AIM: The aim of this retrospective study was to describe and characterize the anesthetic difficulties in this high-risk population...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28321988/a-quality-improvement-initiative-to-optimize-dosing-of-surgical-antimicrobial-prophylaxis
#18
Thomas J Caruso, Ellen Wang, Hayden T Schwenk, David Scheinker, Calida Yeverino, Mary Tweedy, Manjit Maheru, Paul J Sharek
BACKGROUND: The risk of surgical site infections is reduced with appropriate timing and dosing of preoperative antimicrobials. Based on evolving national guidelines, we increased the preoperative dose of cefazolin from 25 to 30 mg·kg(-1) . This quality improvement project describes an improvement initiative to develop standard work processes to ensure appropriate dosing. AIMS: The primary aim was to deliver cefazolin 30 mg·kg(-1) to at least 90% of indicated patients...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28321983/chloroprocaine-for-epidural-anesthesia-in-infants-and-children
#19
REVIEW
Giorgio Veneziano, Joseph D Tobias
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long-term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28321971/risk-factors-for-perioperative-mortality-and-transfusion-in-sacrococcygeal-teratoma-resections
#20
Rebecca S Isserman, Olivia Nelson, Kha M Tran, Lingyu Cai, Marcia Polansky, Julia M Rosenbloom, Theodora K Goebel, Elaina E Lin
BACKGROUND: Sacrococcygeal teratomas are a common congenital tumor. Surgical resection can occur in utero, in the neonatal period, or in the postneonatal period. AIMS: We describe patient and tumor factors associated with mortality and transfusion in this population. METHODS: We did a retrospective chart review of patients who underwent sacrococcygeal teratoma resection between January 1998 and March 2016. Demographic data, transfusion data, and tumor characteristics were collected...
March 21, 2017: Paediatric Anaesthesia
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