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Pediatric regional anesthesia

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https://www.readbyqxmd.com/read/29801659/process-measures-facilitate-maturation-of-pediatric-enhanced-recovery-protocols
#1
Ira L Leeds, Mitchell R Ladd, Margaret H Sundel, Melissa L Fannon, Jessica A George, Emily F Boss, Eric B Jelin
BACKGROUND/PURPOSE: The role of process measures used to predict quality in pediatric colorectal surgery enhanced recovery protocols has not been described. The purpose of this study was to demonstrate the feasibility of abstracting and monitoring process measures over protocol improvement iteration. METHODS: Patients enrolled in the Pediatric Colorectal Enhanced Recovery After Surgery pathway at our institution were grouped by stage of implementation. We used a quality improvement database to compare multistage enhanced recovery process measures and 30-day patient outcomes...
May 4, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29794944/use-of-serratus-plane-block-for-repair-of-coarctation-of-aorta-a-report-of-3-cases
#2
Abhijit Biswas, Igor Luginbuehl, Elod Szabo, Monica Caldeira-Kulbakas, Mark W Crawford, Tobias Everett
OBJECTIVES: The practice of regional anesthesia techniques (thoracic, epidural, paravertebral) in pediatric cardiac surgery enhances perioperative outcomes such as improved perioperative analgesia, decreased stress response, early extubation, and shortened hospital stay. However, these blocks can be technically challenging and can be associated with unacceptable failure rate and complications in infants. For these reasons, regional anesthesia is sometimes avoided in pediatric cardiac surgery...
May 23, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29793567/usage-of-behavior-guidance-techniques-differs-by-provider-and-practice-characteristics
#3
Martha H Wells, Brigid A McCarthy, Chi-Hong Tseng, Clarice S Law
PURPOSE: The purpose of this study was to determine provider and practice characteristics influencing usage of behavior guidance techniques (BGTs). METHODS: A 24-item survey was emailed to 4,117 active AAPD members to identify factors influencing pediatric dentists' use of BGTs. RESULTS: A total of 1,081 surveys were returned, for a 26 percent response rate. The mean age of respondents was 44.7 years old, with recent graduates comprising the largest group (30...
May 15, 2018: Pediatric Dentistry
https://www.readbyqxmd.com/read/29741516/the-influence-of-anesthetics-on-substantia-nigra-tyrosine-hydroxylase-expression-and-tau-phosphorylation-in-the-hypoxic-ischemic-near-term-lamb
#4
Melinda Barkhuizen, Fleur J P van Dijck, Reint K Jellema, Ruth Gussenhoven, Imke Engelbertink, Ralph van Mechelen, Jack P M Cleutjens, Matthias Seehase, Harry W M Steinbusch, Luc J Zimmermann, A W Danilo Gavilanes, Boris W Kramer
BackgroundGeneral anesthetics could protect key neurotransmitter systems, such as the dopaminergic system, from hypoxic-ischemic encephalopathy (HIE) by limiting excessive glutamatergic neurotransmission. However, anesthetics may adversely affect inflammation and tau phosphorylation.MethodsA near-term sheep model of HIE by umbilical cord occlusion (UCO) under anesthesia was used. The effect of propofol and isoflurane on the dopaminergic neurotransmitter phenotype in the substantia nigra (SN) was studied using tyrosine hydroxylase immunohistochemistry...
May 9, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29719743/ultrasound-guided-erector-spinae-plane-block-in-a-child-undergoing-laparoscopic-cholecystectomy
#5
David Terence Thomas, Serkan Tulgar
Erector spinae plane block (ESP) is a recently described regional anesthesia technique that leads to the blockage of both visceral and somatic nerve fibers. While there are anecdotal reports of ESP used in children, none are for laparoscopic procedures. Herein we report a child undergoing laparoscopic cholecystectomy in which ESP was used as part of multimodal anesthesia. Ultrasound-guided ESP block is an easily performed peripheral nerve block that leads to long-lasting postoperative analgesia. It can be successfully used in pediatric laparoscopic procedures such as cholecystectomy and should be kept in mind as an option for multimodal analgesia in children...
February 27, 2018: Curēus
https://www.readbyqxmd.com/read/29700892/prevention-of-perioperative-venous-thromboembolism-in-pediatric-patients-guidelines-from-the-association-of-paediatric-anaesthetists-of-great-britain-and-ireland-apagbi
#6
Judith Morgan, Matthew Checketts, Amaia Arana, Elizabeth Chalmers, Jamie Maclean, Mark Powis, Neil Morton
The Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) Guidelines Working Group on Thromboprophylaxis in Children has reviewed the literature and where possible provided advice on the care of children in the perioperative period. Areas reviewed include the incidence of perioperative venous thromboembolism (VTE), risk factors, evidence for mechanical and chemical prophylaxis, and complications. Safe practice of regional anesthesia with anticoagulant prophylaxis is detailed. In summary, there are few areas of strong evidence...
May 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29619786/comparative-study-of-levobupivacaine-and-bupivacaine-for-bilateral-maxillary-nerve-block-during-pediatric-primary-cleft-palate-surgery-a-randomized-double-blind-controlled-study
#7
Mohamed F Mostafa, Ragaa Herdan, Mohamed Elshazly
BACKGROUND: Cleft lip and palate are common major congenital anomalies. Cleft palate (CP) repair causes pain and needs large doses of intravenous opioids. The risk of postoperative airway obstruction or respiratory depression is high, requiring continuous and vigilant monitoring. The primary outcome was to evaluate the efficacy of using different local anesthetics during bilateral maxillary nerve block (MNB) with general anesthesia on quality of recovery after primary CP repair. We hypothesized that levobupivacaine would be better than bupivacaine...
April 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29619512/a-nationwide-assessment-of-pediatric-surgical-capacity-in-mongolia
#8
Laura F Goodman, Erdenetsetseg Chuluun, Burmaa Sanjaa, Sanchin Urjin, Sarnai Erdene, Narantuya Khad, Adiyasuren Jamiyanjav, Jacob Stephenson, Diana L Farmer
BACKGROUND: Mongolia is a country characterized by its vast distances and extreme climate. An underdeveloped medical transport infrastructure makes patient transfer from outlying regions dangerous. Providing pediatric surgical care locally is crucial to improve the lives of children in the countryside. This is the first structured assessment of nationwide pediatric surgical capacity. METHODS: Operation rates were calculated using data from the Mongolian Center for Health Development and population data from the Mongolian Statistical Information Service...
April 4, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29571799/measurement-of-pediatric-regional-cerebral-blood-flow-from-6-months-to-15-years-of-age-in-a-clinical-population
#9
Aline Carsin-Vu, Isabelle Corouge, Olivier Commowick, Guillaume Bouzillé, Christian Barillot, Jean-Christophe Ferré, Maia Proisy
OBJECTIVES: To investigate changes in cerebral blood flow (CBF) in gray matter (GM) between 6 months and 15 years of age and to provide CBF values for the brain, GM, white matter (WM), hemispheres and lobes. METHODS: Between 2013 and 2016, we retrospectively included all clinical MRI examinations with arterial spin labeling (ASL). We excluded subjects with a condition potentially affecting brain perfusion. For each subject, mean values of CBF in the brain, GM, WM, hemispheres and lobes were calculated...
April 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29509521/practice-patterns-of-dentist-anesthesiologists-in-north-america
#10
Andrew S Young, Michael W Fischer, Nicholas S Lang, Matthew R Cooke
This study provides trends in the discipline of dental anesthesiology. A questionnaire-based survey was sent to 338 members of the American Society of Dentist Anesthesiologists to evaluate practice patterns. One focus of the study was modality of sedation/anesthesia used for dentistry in North America. Age, gender, years in practice, and geographic region of practice were also obtained. Data gathered from the returned questionnaires were entered into an Excel spreadsheet and then imported into JMP Statistical Discovery Software (v12...
2018: Anesthesia Progress
https://www.readbyqxmd.com/read/29481496/short-blunt-injury-in-child-resulting-from-pet-bite
#11
Valthierre Nunes de Lima, Gustavo Antonio Correa Momesso, Luara Teixeira Colombo, Gabriel Mulinari-Santos, Cecília Alves de Sousa, Tárik Ocon Braga Polo, Idelmo Rangel Garcia-Júnior, Leonardo Perez Faverani
The frequency of accidents due to dog bite in children is high, and in the most cases, the child already knows the aggressor dog. Patient, 3 years, female, melanoderm, victim of pet dog attack on the right side of the face region. After the physical examination, conscious sedation was performed with the supplementation of oxygen by pediatrics and the suture by oral and maxillofacial surgeon, under local anesthesia with adrenergic vasoconstrictor, with internal points in the muscles using vicryl 4-0 and in the skin with 5-0 nylon; the lesser number of stitches were performed in the lower region of the wound, allowing spontaneous drainage spaces...
February 23, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29436137/caudal-and-intravenous-dexamethasone-as-an-adjuvant-to-pediatric-caudal-block-a-systematic-review-and-meta-analysis
#12
REVIEW
Change Zhu, Saiji Zhang, Zhiqing Gu, Yiru Tong, Rong Wei
BACKGROUND: Dexamethasone has become a popular additive for regional anesthesia. The aim of this meta-analysis was to assess the effectiveness of this additive on the duration of postoperative analgesia, postoperative vomiting, and possible adverse events in pediatrics. METHODS: We searched databases, conference records, and registered trials for randomized controlled trials. The databases included the Cochrane Library, JBI Database of Systematic Reviews, PubMed, ISI Web of Knowledge, Science-Direct, and Embase...
March 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29406181/local-anaesthetic-dosage-of-peripheral-nerve-blocks-in-children-analysis-of-40-121-blocks-from-the-pediatric-regional-anesthesia-network-database
#13
S Suresh, G S De Oliveira
BACKGROUND: The knowledge regarding appropriate dosage of local anaesthetics for peripheral nerve blocks in children is very scarce. The main objective of the current investigation was to evaluate dosing patterns of local anaesthetics in children receiving peripheral nerve blocks across multiple paediatric hospitals in the USA. We also sought to estimate the incidence of local anaesthetic systemic toxicity. METHODS: This is an observational study using the Pediatric Regional Anesthesia Network (PRAN) database...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29405661/in-children-the-microbiota-of-the-nasopharynx-and-bronchoalveolar-lavage-fluid-are-both-similar-and-different
#14
Kirsten M Kloepfer, Ashley R Deschamp, Sydney E Ross, Stacey L Peterson-Carmichael, Christopher M Hemmerich, Douglas B Rusch, Stephanie D Davis
RATIONALE: Sputum and bronchoalveolar lavage fluid (BALF) are often obtained to elucidate the lower airway microbiota in adults. Acquiring sputum samples from children is difficult and obtaining samples via bronchoscopy in children proves challenging due to the need for anesthesia and specialized procedural expertise; therefore nasopharyngeal (NP) swabs are often used as surrogates when investigating the pediatric airway microbiota. In adults, the airway microbiota differs significantly between NP and BALF samples however, minimal data exist in children...
April 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29398586/prospective-study-of-enhanced-recovery-after-surgery-protocol-in-children-undergoing-reconstructive-operations
#15
K O Rove, M A Brockel, A F Saltzman, M I Dönmez, K E Brodie, D J Chalmers, B T Caldwell, V M Vemulakonda, D T Wilcox
BACKGROUND: Enhanced recovery after surgery (ERAS) protocol is a set of peri-operative strategies to increase speed of recovery. ERAS is well established in adults but has not been well studied in children. OBJECTIVE: The purpose of the current study was to establish the safety and efficacy of an ERAS protocol in pediatric urology patients undergoing reconstructive operations. It was hypothesized that ERAS would reduce length of stay and decrease complications when compared with historical controls...
February 1, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29370900/continuous-erector-spinae-plane-block-for-analgesia-in-pediatric-thoracic-surgery-a-case-report
#16
C Gaio-Lima, C C Costa, J B Moreira, T S Lemos, H L Trindade
Erector spinae plane block has been recently described and it appears as a very promising regional analgesia technique. We report the first continuous erector spinae plane block performed in a pediatric patient for thoracic surgery. A 15-month-old boy, diagnosed with a paracardiac teratoma was scheduled for a tumor resection with a thoracotomy approach. After general anesthesia induction, a continuous erector spinae plane block at T5 level was performed with ropivacaine 0.2%. After surgery, a continuous thoracic interfascial infusion of ropivacaine 0...
January 19, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29352738/persistent-pain-following-common-outpatient-surgeries-in-children-a-multicenter-study-in-italy
#17
Valeria Mossetti, Karen Boretsky, Marinella Astuto, Bruno G Locatelli, David Zurakowski, Rodolfo Lio, Roberta Nicoletti, Valter Sonzogni, Micol Maffioletti, Noemi Vicchio, Giorgio Ivani
INTRODUCTION: The prevalence of persistent postsurgical pain in children is over 20% after major surgeries; however, data are scarce on the prevalence, character, and risk factors among children undergoing common ambulatory surgeries. The primary aim of this study was to evaluate the prevalence of persistent pain following pediatric ambulatory surgery at 1, 3, and 6 months. Secondary aims were to identify risk factors and characterize the pain and consequences of persistent postsurgical pain...
March 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29335054/orbital-mediastinal-and-cervicofacial-subcutaneous-emphysema-after-dental-rehabilitation-in-a-pediatric-patient
#18
William J Boggess, Jeanine Ronan, Neeraj Panchal
Subcutaneous emphysema is a rare possible complication of dental procedures. The majority of the dental literature describes cases of localized areas of subcutaneous emphysema following various dental procedures, with a large number of these cases seen following intraoral surgical procedures. Classically, subcutaneous emphysema occurs within minutes to hours after conclusion of dental procedures and is commonly misdiagnosed as either an allergic reaction or acute post-operative swelling. This case report describes a four-year-old male who underwent dental rehabilitation for routine restorative dentistry without extractions under general anesthesia...
November 1, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/29332115/ultrasound-guided-transversus-abdominis-plane-block-postoperative-analgesia-in-children-with-spinal-dysraphism
#19
Eralp Çevikkalp, Koray Erbüyün, Serpil Erbüyün, Gülay Ok
Pediatric regional anesthesia is widely used to relieve postoperative pain after abdominal surgery. Commonly used techniques of regional anesthesia include lumbar epidural and caudal block. However, the use of central neuraxial blockade has limitations. It is contraindicated in patients with clotting abnormalities, spinal dysraphism with tethered cord syndrome, meningomyelocele, and following spinal surgery with instrumentation. Ultrasound guided transversus abdominis plane block is a new method of regional anesthesia that can be used in settings where central neuraxial blockade is contraindicated...
January 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29319604/the-european-society-of-regional-anaesthesia-and-pain-therapy-american-society-of-regional-anesthesia-and-pain-medicine-recommendations-on-local-anesthetics-and-adjuvants-dosage-in-pediatric-regional-anesthesia
#20
Santhanam Suresh, Claude Ecoffey, Adrian Bosenberg, Per-Anne Lonnqvist, Gildasio S de Oliveira, Oscar de Leon Casasola, José de Andrés, Giorgio Ivani
BACKGROUND AND OBJECTIVES: Dosage of local anesthetics (LAs) used for regional anesthesia in children is not well determined. In order to evaluate and come to a consensus regarding some of these controversial topics, The European Society of Regional Anaesthesia and Pain Therapy (ESRA) and the American Society of Regional Anesthesia and Pain Medicine (ASRA) developed a Joint Committee Practice Advisory on Local Anesthetics and Adjuvants Dosage in Pediatric Regional Anesthesia. METHODS: Representatives from both ASRA and ESRA composed the joint committee practice advisory...
February 2018: Regional Anesthesia and Pain Medicine
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