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Pediatric regional anesthesia

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https://www.readbyqxmd.com/read/27910005/doppler-images-of-intra-pulmonary-shunt-within-atelectasis-in-anesthetized-children
#1
Cecilia M Acosta, Gerardo Tusman, Mauro Costantini, Camila Echevarría, Sergio Pollioto, Diego Abrego, Fernando Suarez-Sipmann, Stephan H Böhm
BACKGROUND: Doppler images of pulmonary vessels in pulmonary diseases associated with subpleural consolidations have been described. Color Doppler easily identifies such vessels within consolidations while spectral Doppler analysis allows the differentiation between pulmonary and bronchial arteries. Thus, Doppler helps in diagnosing the nature of consolidations. To our knowledge, Doppler analysis of pulmonary vessels within anesthesia-induced atelectasis has never been described before...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27893572/pain-management-in-pediatric-burn-patients-review-of-recent-literature-and-future-directions
#2
Omar Pardesi, Gennadiy Fuzaylov
Childhood burns are a profoundly traumatic and painful experience. Despite recognition of the prevalence of burn injuries in children and the severity of the associated pain, burn pain remains undertreated. At the same time, more evidence is emerging to suggest that undertreated pain has serious long-term medical and psychiatric consequences, many of which can be ameliorated with improved pain control. Pain in burn patients is, however, notoriously difficult to treat, perhaps because there is a chronic pain aspect underlying the acute pain that accompanies wound care and procedures...
November 17, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27842864/-use-of-hypnosis-in-radiotherapy-as-an-alternative-to-general-anesthesia-in-pediatric-radiation-oncology
#3
Line Claude, Magali Morelle, Sandrine Mancini, Anita Duncan, Henri Sebban, Christian Carrie, Perrine Marec-Berard
BACKGROUND: General anesthesia (GA) is often needed for radiotherapy (RT) in young children. This study aimed to evaluate the place of the rituals and/or hypnosis in pediatric in a reference center in pediatric radiation oncology in Rhône-Alpes Auvergne. METHODS: This observational study retrospectively collected data on AG in children<5 years treated by RT in Leon-Berard regional center, Lyon, France between 2003 and 2014. Two-time periods, before and after 2008 have been compared, the second one introducing accompaniment methods such as hypnosis systematically...
November 11, 2016: Bulletin du Cancer
https://www.readbyqxmd.com/read/27833495/postoperative-pain-management-of-liver-transplantation-in-cystic-fibrosis-is-it-time-to-start-us-guided-neuraxial-blocks
#4
M Piazza, G Martucci, A Arcadipane
Cystic fibrosis (CF) is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anesthetic techniques improve outcomes by reducing anesthetic drugs and administration of opioids, and hastening extubation, awakening, and restarting respiratory of physiotherapy...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27833485/toward-competency-based-curriculum-application-of-workplace-based-assessment-tools-in-the-national-saudi-arabian-anesthesia-training-program
#5
Ama Boker
BACKGROUND: The anesthesia training program of the Saudi Commission for health specialties has introduced a developed competency-based anesthesia residency program starting from 2015 with the utilization of the workplace-based assessment (WBA) tools, namely mini-clinical exercises (mini-CEX), direct observation of procedural skills (DOPS), and case-based discussion (CBD). OBJECTIVES: This work aimed to describe the process of development of anesthesia-specific list of mini-CEX, DOPS, and CBD tools within the Saudi Arabian Anesthesia Training Programs...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27831957/a-time-out-checklist-for-pediatric-regional-anesthetics
#6
Anna Clebone, Barbara K Burian, David M Polaner
BACKGROUND AND OBJECTIVES: Although pediatric regional anesthesia has a demonstrated record of safety, adverse events, especially those related to block performance issues, still may occur. To reduce the frequency of those events, we developed a Regional Anesthesia Time-Out Checklist using expert opinion and the Delphi method. METHODS: A content development and review was performed by the authors and the Society for Pediatric Anesthesia Quality and Safety Committee...
November 9, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27793105/assessment-of-risk-factors-for-cerebral-oxygen-desaturation-during-neonatal-and-infant-general-anesthesia-an-observational-prospective-study
#7
Ilona Razlevice, Danguole C Rugyte, Loreta Strumylaite, Andrius Macas
BACKGROUND: Cerebral oxygen saturation (rSO2c) decrease from baseline greater than 20 % during infant cardiac surgery was associated with postoperative neurologic changes and neurodevelopmental impairment at 1 year of age. So far, there is no sufficient evidence to support the routine monitoring of rSO2c during general surgical procedures in children. We aimed to find out the frequency of cerebral desaturation 20 % or more from baseline and to identify possible predictors of change in cerebral oxygen saturation during neonatal and infant general surgery...
October 28, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27755489/the-use-of-epinephrine-in-caudal-anesthesia-increases-stroke-volume-and-cardiac-output-in-children
#8
Chang Amber Liu, Jinghu Sui, Charles J Coté, Thomas A Anderson
BACKGROUND AND OBJECTIVES: Caudal anesthesia is a common and effective regional anesthesia technique in pediatric patients. The addition of epinephrine to local anesthetics in caudal anesthesia is a frequent practice; however, changes in hemodynamic and cardiac parameters produced by epinephrine in caudal anesthesia are not well studied. Using data collected with the ICON noninvasive cardiac output monitor, we examined the hemodynamic changes associated with the administration of epinephrine containing local anesthetics during caudal anesthesia in children...
November 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27685797/day-surgery-regional-anesthesia-in-children-safety-and-improving-outcomes-do-they-make-a-difference
#9
Jeremy D Deer, Amod Sawardekar, Santhanam Suresh
PURPOSE OF REVIEW: The objective of this review is to provide an overview of recent developments in pediatric regional anesthesia and elucidate outcomes as it relates to patient safety and overall satisfaction. RECENT FINDINGS: Since the inception of the Pediatric Regional Anesthesia Network database, the acquisition of data has enabled the pediatric anesthesiologist to extrapolate results and translate them into useful outcomes. Despite the growing trend to provide regional anesthesia in the pediatric population, there continues to be a paucity of available research studies to evaluate outcomes of various regional nerve blocks...
September 28, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27550555/caudal-analgesia-and-cardiothoracic-surgery-a-look-at-postoperative-pain-scores-in-a-pediatric-population
#10
Khoa N Nguyen, Heather S Byrd, Jonathan M Tan
AIM: Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use. METHODS: We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013...
November 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27493066/toward-better-pain-management-the-development-of-a-pain-stewardship-program-in-a-tertiary-children-s-hospital
#11
B Randall Brenn, Dinesh K Choudhry, Karen Sacks, Sandra Como-Fluehr, Robert Strain
OBJECTIVE: Despite increased focus on pediatric pain, uncontrolled pain is still a problem for hospitalized pediatric inpatients. A program was designed to find patients with uncontrolled pain and develop a framework to oversee their pain management. This report details the development of a pain stewardship program with data from the first year of its activity. METHODS: Hospitalized inpatients in a tertiary care pediatric center in the mid-Atlantic region were included in the study...
September 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27413097/robert-emmett-farr-1875-1932-a-pioneer-of-pediatric-regional-anesthesia
#12
MaryKate Driscoll, Hyun Kee Chung, Manisha S Desai
Surgeons influence the introduction and development of anesthesia in many ways. Robert Emmett Farr is frequently cited as the first to describe the use of brachial plexus anesthesia in children. A surgeon based in Minneapolis, Minnesota, he passionately believed that regional anesthesia was superior to general anesthesia for many surgical procedures. He wrote extensively promoting other regional techniques, including local infiltration of local anesthetics for pyloromyotomy and harelip repairs, as well as caudal blocks for lower abdominal procedures...
July 13, 2016: Journal of Medical Biography
https://www.readbyqxmd.com/read/27397645/feasibility-and-pharmacokinetics-of-caudal-blockade-in-children-and-adolescents-with-30-50-kg-of-body-weight
#13
Maya Keplinger, Peter Marhofer, Wolfgang Klug, Birgit Reiter, Thomas Stimpfl, Stephan C Kettner, Lena Korf, Markus Zeitlinger, Daniela Marhofer, Lydia Triffterer
BACKGROUND: Caudal blockade, although an important technique of pediatric regional anesthesia, is rarely used in children heavier than 30 kg. This reservation is due to anatomical concerns and lack of pharmacokinetic data. We therefore set out to evaluate, in pediatric patients weighing 30-50 kg, the feasibility of ultrasound-guided caudal blockade and the pharmacokinetics of caudally administered ropivacaine. METHODS: Twenty consecutive children were included. General anesthesia was used to ensure a secured airway...
November 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27370517/perioperative-management-in-children-with-chronic-pain
#14
REVIEW
Meredith R Brooks, Brenda Golianu
Children with chronic pain often undergo surgery and effective perioperative management of their pain can be challenging. Identification of the pediatric chronic pain patient preoperatively and development of a perioperative pain plan may help ensure a safer and more comfortable perioperative course. Successful management usually requires multiple different classes of analgesics, regional anesthesia, and adjunctive nonpharmacological therapies. Neuropathic and oncological pain can be especially difficult to treat and usually requires an individualized approach...
August 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27222065/electroacupuncture-ameliorates-propofol-induced-cognitive-impairment-via-an-opioid-receptor-independent-mechanism
#15
Yan Liu, Xin-Juan Wang, Na Wang, Cai-Lian Cui, Liu-Zhen Wu
While general anesthesia is known to induce cognitive deficits in elderly and pediatric patients, its influence on adults is less well-characterized. The present study was designed to evaluate the influence of propofol on the learning and memory of young adult rats, as well as the potential neuroprotective role of electroacupuncture (EA) in propofol-induced cognitive impairment. Intravenous anesthesia with propofol was administered to young adult male Sprague-Dawley (SD) rats for 6 h, and EA was administered three times before and after anesthesia...
2016: American Journal of Chinese Medicine
https://www.readbyqxmd.com/read/27203396/regional-anesthesia-is-cost-effective-in-preventing-unanticipated-hospital-admission-in-pediatric-patients-having-anterior-cruciate-ligament-reconstruction
#16
Denise Michelle Hall-Burton, Mark E Hudson, Jan S Grudziak, Sarah Cunningham, Katherine Boretsky, Karen R Boretsky
BACKGROUND AND OBJECTIVES: Published studies have shown a benefit of regional anesthesia (RA) in preventing unplanned hospital admissions (UHAs) and decreasing hospital costs after orthopedic surgeries in adults but not pediatric patients. We performed a retrospective analysis to assess the effect of converting from an opioid to RA-based approach to pain management after pediatric anterior cruciate ligament (ACL) reconstruction. METHODS: The records of patients having ACL reconstruction were reviewed...
July 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27195638/the-use-of-neuraxial-catheters-for-postoperative-analgesia-in-neonates-a-multicenter-safety-analysis-from-the-pediatric-regional-anesthesia-network
#17
Justin B Long, Anita S Joselyn, Tarun Bhalla, Joseph D Tobias, Gildasio S De Oliveira, Santhanam Suresh
BACKGROUND: Currently, there is limited evidence to support the safety of neuraxial catheters in neonates. Safety concerns have been cited as a major barrier to performing large randomized trials in this population. The main objective of this study is to examine the safety of neuraxial catheters in neonates across multiple institutions. Specifically, we sought to determine the incidence of overall and individual complications encountered when neuraxial catheters were used for postoperative analgesia in neonates...
June 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27108820/effects-of-carbon-dioxide-insufflation-on-regional-cerebral-oxygenation-during-laparoscopic-surgery-in-children-a-prospective-study
#18
Ayca Tas Tuna, Ibrahim Akkoyun, Sevtap Darcin, Onur Palabiyik
BACKGROUND AND OBJECTIVES: Laparoscopic surgery has become a popular surgical tool when compared to traditional open surgery. There are limited data on pediatric patients regarding whether pneumoperitoneum affects cerebral oxygenation although end-tidal CO2 concentration remains normal. Therefore, this study was designed to evaluate the changes of cerebral oxygen saturation using near-infrared spectroscope during laparoscopic surgery in children. METHODS: The study comprised forty children who were scheduled for laparoscopic (Group L, n=20) or open (Group O, n=20) appendectomy...
May 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27089835/chloroprocaine-local-anesthetic-systemic-toxicity-in-a-9-month-infant-with-paravertebral-catheter
#19
Maria A Hernandez, Karen Boretsky
Regional anesthesia use in pediatric patients has a good safety profile. 2-Chloroprocaine is used frequently in infants due to rapid onset, lack of accumulation, and rapid plasma degradation. We present a case of local anesthetic systemic toxicity following the administration of 3% 2-chloroprocaine through a paravertebral catheter in an infant. The episode lasted 40 s followed by complete recovery. The infrequent reporting of local anesthetic systemic toxicity and limited duration of symptoms supports the continued use of 2-chloroprocaine in infants...
June 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27066206/the-use-of-emla-cream-reduces-the-pain-of-skin-puncture-associated-with-caudal-block-in-children
#20
Eun Kyung Choi, YoungHo Ro, Sung-Sik Park, Ki-Bum Park
BACKGROUND: Caudal block is a popular regional anesthesia in children undergoing infraumbilical surgeries including inguinal hernia repair and orchiopexy. We evaluated the efficacy of eutectic mixture of local anesthetic (EMLA) cream for reducing needle insertion pain during caudal block in pediatric patients. METHODS: Forty-one children between the ages of 13 months and 5 years undergoing infraumbilical surgery were randomized to receive either topical EMLA or placebo cream over the sacral hiatus one hour before caudal block...
April 2016: Korean Journal of Anesthesiology
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