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Anesthesia pediatric airway

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https://www.readbyqxmd.com/read/30097185/-anesthesia-and-perioperative-challenges-for-surgical-separation-of-thoraco-omphalopagus-twins-case-report
#1
Milton Halyson Benevides de Freitas, Luciana Cavalcanti Lima, Tania Cursino de Menezes Couceiro, Maria Célia Ferreira da Costa, Márcio Handerson Benevides de Freitas
BACKGROUND AND OBJECTIVES: Conjoined twins are monozygotic twins physically joined at some part of the body. This is a rare phenomenon, estimated between 1:50,000 to 1:200,000 births. The objective of this report is to present the anesthetic management and the perioperative challenges for a separation surgery. CASE REPORT: Thoraco-omphalopagus twins were diagnosed by ultrasound and were followed by the fetal medicine team of the service. After 11hours of cesarean, the pediatric surgical team chose to separate the twins...
August 7, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/30059398/laryngeal-mask-airway-versus-other-airway-devices-for-anesthesia-in-children-with-an-upper-respiratory-tract-infection-a-systematic-review-and-meta-analysis-of-respiratory-complications
#2
Ana Lygia R de Carvalho, Roberto B Vital, Carlos C S de Lira, Igor B Magro, Patrícia T S Sato, Laís H N Lima, Leandro G Braz, Norma S P Módolo
There is an association between upper respiratory tract infection (URTI) and an increased incidence of perioperative respiratory adverse events (PRAEs), which is a major risk for morbidity during pediatric anesthesia. The aim of the present study was to compare the risk of PRAEs among different airway devices during anesthesia in children with a URTI. A systematic review according to the Cochrane Handbook and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. Only randomized clinical trials evaluating anesthesia in children with a URTI and who were submitted to any of the airway devices were included...
July 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/30052550/gastric-ultrasound-for-the-regional-anesthesiologist-and-pain-specialist
#3
Stephen C Haskins, Richelle Kruisselbrink, Jan Boublik, Christopher L Wu, Anahi Perlas
This article in our series on point-of-care ultrasound (US) for the regional anesthesiologist and pain management specialist describes the emerging role of gastric ultrasonography. Although gastric US is a relatively new point-of-care US application in the perioperative setting, its relevance for the regional anesthesiologist and pain specialist is significant as our clinical practice often involves providing deep sedation without a secured airway. Given that pulmonary aspiration is a well-known cause of perioperative morbidity and mortality, the ability to evaluate for NPO (nil per os) status and risk stratify patients scheduled for anesthesia is a powerful skill set...
July 27, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/30004614/work-of-breathing-for-cuffed-and-uncuffed-pediatric-endotracheal-tubes-in-an-in-vitro-lung-model-setting
#4
Jörg Thomas, Markus Weiss, Vincenzo Cannizzaro, Christian Peter Both, Alexander Robert Schmidt
BACKGROUND: Over the last decade, cuffed endotracheal tubes are increasingly used in pediatric anesthesia and also in pediatric intensive care. However, the smaller inner diameter of cuffed endotracheal tubes and, implicitly, the increased endotracheal tube resistance is still a matter of debate. AIMS: This in vitro study investigated work of breathing and inspiratory airway pressures in cuffed and uncuffed endotracheal tubes and the impact of pressure support ventilation and automatic tube compensation...
July 13, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29962612/comparative-evaluation-between-sevoflurane-and-propofol-for-endotracheal-intubation-without-muscle-relaxants-in-pediatric-cleft-surgeries
#5
Harish Karanth, U S Raveendra, Rithesh B Shetty, Pramal Shetty, Padmini Thalanjeri
Background and Objectives: Endotracheal intubation is the most important and crucial step during administration of general anesthesia. It is more so in pediatric patients with associated deformities of cleft lip, palate, and alveolus. Propofol, an intravenous (i.v.) induction agent, has profound depressant effect on airway reflexes with a quick and smoother induction. Similarly, sevoflurane, an inhalational agent, has relatively pleasant smell, low airway irritability, and more cardiostable properties...
April 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29952648/pilot-study-comparing-nasal-vs-oral-intubation-for-dental-surgery-by-physicians-nurse-anesthetists-and-trainees
#6
J Patrick Bowman, Michael P Nedley, Kimberly A Jenkins, Charles R Fahncke
The purpose of this article was to determine if pediatric dental treatment under general anesthesia utilizing orotracheal intubation takes longer than using nasotracheal intubation techniques. Twenty-six American Society of Anesthesiologists Physical Status Classification I and II pediatric dental patients, ages 2-8 years treated under general anesthesia, were assigned to 1 of 2 groups: (a) nasotracheal intubation (control, n = 13), (b) orotracheal intubation (experimental, n = 13). Times for intubation, radiographic imaging, and dental procedures, as well as total case time were quantified...
2018: Anesthesia Progress
https://www.readbyqxmd.com/read/29937023/outpatient-curettage-and-electrocautery-as-an-alternative-to-primary-surgical-closure-for-pediatric-gastrocutaneous-fistulae
#7
Naomi-Liza Denning, Ibrahim Abd El-Shafy, John Hagen, Steven Stylianos, Jose M Prince, Aaron M Lipskar
BACKGROUND: The development of a gastrocutaneous fistula (GCF) after gastrostomy tube removal is a frequent complication that occurs 5%-45% of the time. Conservative therapy with chemical cauterization is frequently unsuccessful, and surgical GCF repair with open primary layered closure of the gastrotomy is often required. We describe an alternative approach of GCF closure that is an outpatient, less invasive procedure that allows patients to avoid the comorbidities of general endotracheal anesthesia and intraabdominal surgery...
September 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29851190/choosing-wisely-in-pediatric-anesthesia-an-interpretation-from-the-german-scientific-working-group-of-paediatric-anaesthesia-wakka
#8
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
May 30, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29750689/a-prospective-observational-study-of-technical-difficulty-with-glidescope-guided-tracheal-intubation-in-children
#9
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...
August 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29709387/the-fork-in-the-road-a-laryngeal-filter-airway-foreign-body
#10
Jacob E Kuperstock, J Pieter Noordzij
OBJECTIVE: Upper aero-digestive tract foreign body management can be complicated and life threatening in both adult and pediatric populations. The variation seen with foreign bodies including shape, material, and duration of ingestion can impact clinical decision making and management. The objective of this report is to demonstrate a complicated case of upper airway obstruction by a plastic fork. METHOD: This case report presents an adult with ingestion of an intact plastic fork with acute laryngeal and cervical esophageal obstruction...
July 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29703020/flumazenil-reduces-respiratory-complications-during-anesthesia-emergence-in-children-with-preoperative-upper-respiratory-tract-infections
#11
Ruiqiang Sun, Guolin Wang, Xuesong Gao, Shuzhen Wang
Despite its benignity, upper respiratory infections (URIs) 1 increase the risk of postoperative respiratory complications during the perioperative and postoperative periods. Flumazenil could improve the symptoms of respiratory obstruction.To evaluate the effect of flumazenil on the occurrence of respiratory complications during anesthesia emergence of children with preoperative URI.This was a prospective study of 164 consecutive pediatric patients who underwent strabismus surgery under general anesthesia at the Tianjin Eye Hospital between August 2016 and April 2017...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29697466/perioperative-considerations-for-airway-management-and-drug-dosing-in-obese-children
#12
Jerrold Lerman, Karin Becke
PURPOSE OF REVIEW: Childhood obesity, a phenomenon that is increasing globally, holds substantial relevance for pediatric anesthesia. In particular, understanding the nuances of airway management and drug dosing in obese children can be daunting. RECENT FINDINGS: Respiratory adverse events and challenges in managing the airway may be anticipated. In addition, drug-dosing strategies for the obese child are complex and poorly understood although recent advances have clarified the optimal dosing for anesthetics in these children...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29687523/safety-of-anesthesia-for-children-with-mucopolysaccharidoses-a-retrospective-analysis-of-54-patients
#13
Vittorio Scaravilli, Alberto Zanella, Valentina Ciceri, Mariagrazia Bosatra, Claudia Flandoli, Alessia La Bruna, Simone Sosio, Rossella Parini, Serena Gasperini, Antonio Pesenti, Alessandra Moretto
BACKGROUND: Complications are common during anesthesia for patients with mucopolysaccharidoses. San Gerardo Hospital (Italy) is a reference center for mucopolysaccharidoses with a dedicated pediatric anesthesia service. AIMS: This study aims to evaluate the safety of anesthesia for mucopolysaccharidoses patients, describe their anesthetic management at our institution, and assess risk factors for complications. METHODS: The anesthetic charts of mucopolysaccharidoses patients admitted from January 1999 to December 2014 were retrospectively analyzed...
May 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29643628/pediatric-critical-incidents-reported-over-15-years-at-a-tertiary-care-teaching-hospital-of-a-developing-country
#14
Shemila Abbasi, Fauzia Anis Khan, Sobia Khan
Background and Aims: The role of critical incident (CI) reporting is well established in improving patient safety but only a limited number of available reports relate to pediatric incidents. Our aim was to analyze the reported CIs specific to pediatric patients in our database and to reevaluate the value of this program in addressing issues in pediatric anesthesia practice. Material and Methods: Incidents related to pediatric population from neonatal period till the age of 12 years were selected...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628599/temporomandibular-joint-ankylosis-a-pediatric-difficult-airway-management
#15
Anoop Sharma, Deepak Dwivedi, Ram Murti Sharma
Intubating a pediatric patient with temporomandibular joint ankylosis is a daunting task, and it becomes more challenging with limited mouth opening. Fiberoptic nasotracheal intubation technique is considered a gold standard. We describe an improvised technique of securing airway in the absence of appropriate-sized fiberoptic scope. The endotracheal tube inserted in the left nostril for maintaining depth of anesthesia was advanced under vision by the fiberoptic scope inserted into the right nostril, and with external laryngeal manipulation, the airway was secured with no complications...
January 2018: Anesthesia, Essays and Researches
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
#16
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/29613935/the-use-of-emergency-physicians-to-deliver-anesthesia-for-orthopaedic-surgery-in-austere-environments-the-expansion-of-the-emergency-physician-s-general-anesthesia-syllabus-to-orthopaedic-surgery
#17
Ogedad Pierre, John F Lovejoy, Robert Stanton, Richard Skupski, Harold Previl, Jerry Bernard, Lia Losonczy, Mark Walsh
BACKGROUND: Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29548354/preoperative-anesthesia-evaluation
#18
Joseph D Tobias
The preoperative evaluation is the first step in ensuring the safe conduct of anesthetic care in pediatric patients of all ages. Over time, this process has changed significantly from a time when patients were admitted to the hospital the night before surgery to a time when the majority of patients, including those scheduled for major surgical procedures, arrive the day of surgery. For most patients, the preoperative examiantion can be conducted over the phone by a trained nurse or on-line via a survey thereby eliminating the need for a separate visit merely for the preoperative evaluation...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29509521/practice-patterns-of-dentist-anesthesiologists-in-north-america
#19
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...
December 0: Anesthesia Progress
https://www.readbyqxmd.com/read/29509517/airway-management-for-a-pediatric-patient-with-a-tracheal-bronchus
#20
Masanori Tsukamoto, Jun Hirokawa, Takashi Hitosugi, Takeshi Yokoyama
Tracheal bronchus is an ectopic bronchus almost arising from the right side of the tracheal wall above the carina. The incidence of a tracheal bronchus is reported as 0.1 to 3%. We experienced a patient with tracheal bronchus that was incidentally found at induction of anesthesia. Endotracheal intubation in a patient with tracheal bronchus might cause obstruction of the tracheal bronchus, although in this case, ventilation was not impaired.
December 0: Anesthesia Progress
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