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Pediatric Anesthesia

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https://www.readbyqxmd.com/read/29777565/unanticipated-hospital-admission-in-pediatric-patients-with-congenital-heart-disease-undergoing-ambulatory-noncardiac-surgical-procedures
#1
Koichi Yuki, Sophia Koutsogiannaki, Sandra Lee, James A DiNardo
BACKGROUND: An increasing number of surgical and nonsurgical procedures are being performed on an ambulatory basis in children. Analysis of a large group of pediatric patients with congenital heart disease undergoing ambulatory procedures has not been undertaken. AIMS: The objective of this study was to characterize the profile of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis at our institution, to determine the incidence of adverse cardiovascular and respiratory adverse events, and to determine the risk factors for unscheduled hospital admission...
May 18, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29776869/outcomes-of-externalized-pyeloureteral-versus-internal-ureteral-stent-in-pediatric-robotic-assisted-laparoscopic-pyeloplasty
#2
D I Chu, D Shrivastava, J P Van Batavia, D K Bowen, C C Tong, C J Long, D A Weiss, A R Shukla, A K Srinivasan
INTRODUCTION: After pyeloplasty, urinary drainage options include internal double-J (DJ) ureteral stents or externalized pyeloureteral (EPU) stents, which can avoid bladder symptoms and additional anesthetic exposure from stent removal. Comparative outcome studies, however, are lacking following primary pediatric robotic-assisted laparoscopic pyeloplasty (RALP). OBJECTIVE: To compare operative success, operative time, hospitalization, and postoperative complications of EPU versus DJ stents following RALP...
May 7, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#3
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29760560/spinal-anesthesia-instead-of-general-anesthesia-for-infants-undergoing-tendon-achilles-lengthening
#4
EDITORIAL
Mohammad AlSuhebani, David P Martin, Lance M Relland, Tarun Bhalla, Allan C Beebe, Amanda T Whitaker, Walter Samora, Joseph D Tobias
Spinal anesthesia (SA) has been used relatively sparingly in the pediatric population, as it is typically reserved for patients in whom the perceived risk of general anesthesia is high due to comorbid conditions. Recently, concern has been expressed regarding the potential long-term neurocognitive effects of general anesthesia during the early stages of life. In view of this, our center has developed a program in which SA may be used as the sole agent for applicable surgical procedures. While this approach in children is commonly used for urologic or abdominal surgical procedures, there have been a limited number of reports of its use for orthopedic procedures in this population...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29760370/using-eye-tracking-technology-to-compare-the-effectiveness-of-malignant-hyperthermia-cognitive-aid-design
#5
Roderick King, Jaber Hanhan, T Kyle Harrison, Alex Kou, Steven K Howard, Lindsay K Borg, Cynthia Shum, Ankeet D Udani, Edward R Mariano
Background: Malignant hyperthermia is a rare but potentially fatal complication of anesthesia, and several different cognitive aids designed to facilitate a timely and accurate response to this crisis currently exist. Eye tracking technology can measure voluntary and involuntary eye movements, gaze fixation within an area of interest, and speed of visual response and has been used to a limited extent in anesthesiology. Methods: With eye tracking technology, we compared the accessibility of five malignant hyperthermia cognitive aids by collecting gaze data from twelve volunteer participants...
May 15, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29755652/correlation-of-mdr1-gene-polymorphism-with-propofol-combined-with-remifentanil-anesthesia-in-pediatric-tonsillectomy
#6
YunLong Zhang, Yongpei Li, Hongfa Wang, Fang Cai, Sheliang Shen, Xiaopan Luo
The motive of this study was to investigate the interaction between polymorphisms in the MDR1 gene and anesthetic effects following pediatric tonsillectomy. In total, 240 children undergoing tonsillectomy with preoperative propofol-remifentanil anesthesia were selected. Genomic DNA was extracted from the peripheral blood of children after operation, and the MDR1 gene polymorphisms of 2677 G>T/A, 1236 C>T and 3435 C>T were detected by direct sequencing. We tested mean arterial pressure, diastolic blood pressure, systolic blood pressure, and heart rate at several time-points: T0 (5 mins after the repose), T1 (0 min after tracheal intubation), T2 (5 mins after the tracheal intubation), T3 (0 min after the tonsillectomy), T4 (0 min after removal of the mouth-gag) and T5 (5 min after the extubation)...
April 17, 2018: Oncotarget
https://www.readbyqxmd.com/read/29752853/dexmedetomidine-for-the-reduction-of-emergence-delirium-in-children-undergoing-tonsillectomy-with-propofol-anesthesia-a-double-blind-randomized-study
#7
Adelais G Tsiotou, Anna Malisiova, Elena Kouptsova, Maria Mavri, Maria Anagnostopoulou, Evagelia Kalliardou
BACKGROUND: Postanesthesia emergence delirium is a motor agitation state complicating pediatric anesthesia. We investigated the efficacy of dexmedetomidine in reducing emergence delirium in children undergoing tonsillectomy with and without adenoidectomy using total intravenous anesthesia with propofol. METHODS: This was a prospective, single-center, double-blind, randomized study. The primary outcome was the presence or absence of emergence delirium with and without dexmedetomidine...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29752842/correlation-between-duration-of-preoperative-fasting-and-emergence-delirium-in-pediatric-patients-undergoing-ophthalmic-examination-under-anesthesia-a-prospective-observational-study
#8
Puneet Khanna, Kulbhushan Saini, Renu Sinha, Niseville Nisa, Shailendra Kumar, Souvik Maitra
BACKGROUND: Preoperative fasting in children can cause anxiety, which may ultimately lead to postoperative emergence delirium. However, no data are available whether duration of preoperative fasting correlates with postoperative emergence delirium. AIMS: The aim of this study was to identify if there is any correlation between the duration of preoperative fasting and emergence delirium in children undergoing ophthalmic examination under anesthesia. METHODS: In this prospective observational study, 100 children between the age group 2-6 years of American Society of Anesthesiologists physical status I or II, scheduled for examination of the eye under general anesthesia with sevoflurane were recruited...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29750690/rates-of-perioperative-respiratory-adverse-events-among-caucasian-and-african-american-children-undergoing-general-anesthesia
#9
Sarah Tariq, Madiha Syed, Timothy Martin, Xu Zhang, Michael Schmitz
BACKGROUND: Perioperative respiratory adverse events (PRAEs) account for the major cause of morbidity and mortality in children undergoing general anesthesia. In our institutional clinical practice, we suspected that African American children experienced untoward respiratory events more frequently than other racial groups. Identification of high-risk groups can guide decision making in the perioperative period, and aggressive optimization of specific care can enhance safety and improve outcomes...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29750689/a-prospective-observational-study-of-technical-difficulty-with-glidescope-guided-tracheal-intubation-in-children
#10
Bin Zhang, Harshad G Gurnaney, Paul A Stricker, Jorge A Galvez, Rebecca S Isserman, John E Fiadjoe
BACKGROUND: The GlideScope Cobalt is one of the most commonly used videolaryngoscopes in pediatric anesthesia. Although visualization of the airway may be superior to direct laryngoscopy, users need to learn a new indirect way to insert the tracheal tube. Learning this indirect approach requires focused practice and instruction. Identifying the specific points during tube placement, during which clinicians struggle, would help with targeted education. We conducted this prospective observational study to determine the incidence and location of technical difficulties using the GlideScope, the success rates of various corrective maneuvers used, and the impact of technical difficulty on success rate...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29750661/spontaneous-conversions-of-supraventricular-tachycardia-to-sinus-rhythm-in-children-after-premedication-with-intranasal-dexmedetomidine-a-case-report
#11
Magnus Hultin, Erik Sundberg
Intranasal dexmedetomidine administered as premedication before anesthesia and cardioversion appears to have the potential to facilitate the return of sinus rhythm. Two children, 3.5 and 1.5 years old, with recurrent supraventricular tachycardia in need of cardioversion have now on several occasions spontaneously returned to sinus rhythm within 20-40 minutes after intranasal administration of dexmedetomidine (4 μg/kg) with a mucosal atomization device. Both children were observed on all occasions at the pediatric outpatient clinic and could return home within 2 hours of cardioversion...
May 9, 2018: A&A practice
https://www.readbyqxmd.com/read/29750630/esophageal-atresia-with-tracheoesophageal-fistula-and-gastroesophageal-reflux-in-children-dental-considerations-and-case-report
#12
J Arturo Garrocho-Rangel, Juana M Arvizu-Rivera, Nadia P Campos-Lara, Miguel A Rosales-Berber, Amaury Pozos-Guillén
BACKGROUND: Esophageal Atresia (EA) is defined as the congenital interruption of the continuity of the esophagus. Pediatric patients also have other congenital conditions, such as Tracheo-Esophageal Fistula (TEF). CASE REPORT: A 7-year-old male with TEF referred by a Pediatric Cardiologist, with the principal complaint of "severe and generalized tooth wearing". Considering that the patient was systemically stable, it was decided to perform the oral procedures under local anesthesia and rubber-dam isolation with an antimicrobial prophylaxis regimen...
May 11, 2018: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/29750625/trends-and-characteristics-of-pediatric-dentistry-patients-treated-under-general-anesthesia
#13
Maxwell N Rudie, Michael M Milano, Michael W Roberts, Kimon Divaris
PURPOSE: The aims of this study were to describe the demographic characteristics of pediatric dentistry patients undergoing dental rehabilitation under general anesthesia (DRGA) at UNC-Chapel Hill during the last 13 years and identify factors associated with multiple (1 versus 2 or more) DRGA visits during that timeframe. STUDY DESIGN: Administrative claims data were used to identify children and adolescents (age <18 years) who underwent DRGA between 1/1/2002 and 12/31/2014 at the UNC Hospitals system...
May 11, 2018: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/29749883/rapid-sequence-brain-magnetic-resonance-imaging-for-chiari-i-abnormality
#14
James Pan, Jennifer L Quon, Eli Johnson, Bryan Lanzman, Anjeza Chukus, Allen L Ho, Michael S B Edwards, Gerald A Grant, Kristen W Yeom
OBJECTIVE Fast magnetic resonance imaging (fsMRI) sequences are single-shot spin echo images with fast acquisition times that have replaced CT scans for many conditions. Introduced as a means of evaluating children with hydrocephalus and macrocephaly, these sequences reduce the need for anesthesia and can be more cost-effective, especially for children who require multiple surveillance scans. However, the role of fsMRI has yet to be investigated in evaluating the posterior fossa in patients with Chiari I abnormality (CM-I)...
May 11, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29749244/influence-of-perioperative-hypothermia-on-blood-clotting-in-children
#15
A Trckova, P Stourac
OBJECTIVES: The decrease of body temperature is one of the causes of blood clotting disorders. BACKGROUND: Accidental hypothermia during anesthesia is a common condition and children, especially newborns, are the most sensitive patients to the side effects of hypothermia. METHODS: Web of Science, SCOPUS and PubMed search was performed to retrieve both original and review articles addressing both, hypothermia during surgery and coagulation disorder in pediatric patients...
2018: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29747622/postoperative-dental-morbidity-in-children-following-dental-treatment-under-general-anesthesia
#16
Yu-Hsuan Hu, Aileen Tsai, Li-Wei Ou-Yang, Li-Chuan Chuang, Pei-Ching Chang
BACKGROUND: General anesthesia has been widely used in pediatric dentistry in recent years. However, there remain concerns about potential postoperative dental morbidity. The goal of this study was to identify the frequency of postoperative dental morbidity and factors associated with such morbidity in children. METHODS: From March 2012 to February 2013, physically and mentally healthy children receiving dental treatment under general anesthesia at the Department of Pediatric Dentistry of the Chang Gung Memorial Hospital in Taiwan were recruited...
May 10, 2018: BMC Oral Health
https://www.readbyqxmd.com/read/29747378/treating-mucocele-in-pediatric-patients-using-a-diode-laser-three-case-reports
#17
Sara M Bagher, Ayman M Sulimany, Martin Kaplan, Cheen Y Loo
A mucocele is the most common minor salivary gland disease and among the most common biopsied oral lesions in pediatric patients. Clinically, a mucocele appears as a round well-circumscribed painless swelling ranging from deep blue to mucosa alike in color. Mucoceles rarely resolve on their own and surgical removal under local anesthesia is required in most cases. Different treatment options are described in the literature, including cryosurgery, intra-lesion injection of corticosteroid, micro-marsupialization and conventional surgical removal using a scalpel, and laser ablation...
May 9, 2018: Dentistry journal
https://www.readbyqxmd.com/read/29746281/aesthetic-unit-boundary-approach-of-large-fibroadenoma-resection
#18
Chien-Wei Wang, Robyn M Hatley, Kenneth Christian Walters, Walter L Pipkin, Diane Bairas, Jack C Yu
BACKGROUND: Fibroadenomas are the most common benign breast tumors in adolescents. Surgical excision is indicated when the tumor becomes large or symptomatic. Multiple approaches have been described. However, unsightly scars, excess skin, and breast asymmetry are common challenges after tumor resection. The aims of our study were to describe a concentric circumareolar approach combining the round-block technique and geometric principles in the management of large benign breast tumors...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29742889/intraoperative-neurophysiological-monitoring-a-review-of-techniques-used-for-brain-tumor-surgery-in-children
#19
REVIEW
Keewon Kim, Charles Cho, Moon-Suk Bang, Hyung-Ik Shin, Ji-Hoon Phi, Seung-Ki Kim
Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues...
May 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29741974/the-effect-of-different-intraabdominal-pressures-on-thiol-disulfide-homeostasis-in-children-who-underwent-ambulatory-laparoscopic-surgery-a-prospective-randomized-study
#20
Seyda Efsun Ozgunay, Yasemin Ustundag, Derya Karasu, Ilken Uguz, Ozcan Erel, Gulsen Korfali, Mete Kaya
BACKGROUND: Thiol/disulfide homeostasis is a significant parameter in determining the oxidative stress response after ischemia and reperfusion. We aimed to investigate the effects of applying different intraabdominal pressure (IAP) on thiol/disulfide homeostasis, ischemia-modified albumin (IMA) levels, and hemodynamics in pediatric laparoscopic surgery. MATERIALS AND METHODS: Blood samples were collected from 36 pediatric patients who were planned to undergo laparoscopic surgery for nonpalpable testis or varicocele under general anesthesia, immediately after intubation as the baseline and 5 minutes after abdominal desufflation for determining the thiol/disulfide, and IMA levels...
May 9, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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