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Pediatric sedation

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https://www.readbyqxmd.com/read/29459134/upper-pole-access-is-safe-and-effective-for-pediatric-percutaneous-nephrolithotomy
#1
Sedat Oner, Ahsen Karagozlu Akgul, Murat Demirbas, Efe Onen, Murat Aydos, Abdullah Erdogan
INTRODUCTION: Upper pole access in percutaneous nephrolithotomy (PCNL) provides a straight tract to the ureter, resulting in easier placement of a guidewire to the ureter, good exposure of the pelvis, calices, and upper ureter, and comfortable manipulations. However, despite these benefits, upper pole access is usually avoided because of the risk of chest complications in both pediatric and adult patients. OBJECTIVE: We aimed to evaluate the safety and morbidity of single upper pole access in pediatric patients undergoing PCNL...
February 2, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29456702/application-of-pre-injection-of-dexmedetomidine-of-different-doses-in-pediatric-intravenous-general-anesthesia-without-tracheal-intubation
#2
Mi Zhou, Qiang Wang, Qiong Zhang, Yifei Liu, Leyun Zhan, Aihua Shu
This study observed the clinical efficacy of pre-injection of dexmedetomidine of different doses before surgery and the adverse reactions during the recovery period in pediatric intravenous general anesthesia without tracheal intubation. Pediatric patients who received general anesthesia without tracheal intubation before surgery from January 2016 to March 2017 were randomly divided into four groups (n=30), and were respectively treated with intravenous pump infusion of loaded dexmedetomidine of high-dose (2...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29446987/dexmedetomidine-decreases-postoperative-pain-and-narcotic-use-in-children-undergoing-alveolar-bone-graft-surgery
#3
Mariela M Lopez, Derrick Zech, Judith L Linton, Steven J Blackwell
OBJECTIVE: Dexmedetomidine is a parenteral agent that combines the benefits of cooperative sedation, anxiolysis, and analgesia without the risks of respiratory depression. Off-label use has been reported in children. We have introduced dexmedetomidine for use in patients having undergone alveolar bone graft (ABG). The objective is to demonstrate the value and safety of postoperative dexmedetomidine infusion in a non-ICU setting following ABG. DESIGN: A retrospective review was performed on patients who underwent ABG by the senior author...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29446671/unenhanced-mri-as-an-alternative-to-99m-tc-labeled-dimercaptosuccinic-acid-scintigraphy-in-the-detection-of-pediatric-renal-scarring
#4
Colbey W Freeman, Talissa A Altes, Patrice K Rehm, Eduard E de Lange, Luke Lancaster, John P Mugler, James T Patrie, Sean Corbett, Carlos Leiva-Salinas, Lucia Flors
OBJECTIVE: The purpose of this study was to determine whether unenhanced MRI without sedation is a feasible substitute for dimercaptosuccinic acid (DMSA) scintigraphy in the detection of renal scars in pediatric patients. SUBJECTS AND METHODS: Patients scheduled for 99mTc-labeled DMSA scintigraphy for assessment of possible renal scars were recruited to undergo unenhanced MRI (free-breathing fat-suppressed T2-weighted single-shot turbo spin-echo and T1-weighted gradient-echo imaging, 13 minutes' total imaging time)...
February 15, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29432946/postoperative-cerebral-infarction-risk-factors-and-postoperative-management-of-pediatric-moyamoya-disease-patients
#5
Shinsuke Muraoka, Yoshio Araki, Goro Kondo, Michihiro Kurimoto, Yoshiki Shiba, Kenji Uda, Shinji Ota, Sho Okamoto, Toshihiko Wakabayashi
OBJECT: Though revascularization surgery for moyamoya disease patients can effectively prevent ischemic events and thus improve the long-term clinical outcome, the incidence of postoperative ischemic complications affects patients' quality of life. This study aimed to clarify the risk factors associated with postoperative ischemic complications and to discuss the appropriate perioperative management. METHODS: Fifty-eight revascularization operations were performed in 37 children with moyamoya disease...
February 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29431909/dermatologic-surgery-in-children-an-update-on-indication-anesthesia-analgesia-and-potential-perioperative-complications
#6
REVIEW
Diana Crisan, Karin Scharffetter-Kochanek, Sabine Kastler, Maria Crisan, Avram Manea, Katja Wagner, Lars Alexander Schneider
BACKGROUND: Children undergoing dermatosurgical procedures require, unlike adults, particular attention; the administration of various analgesics, anesthetics or sedatives requires a thorough knowledge of drug pharmacokinetics and pharmacodynamics. Furthermore, there are concerns that drugs used for sedation/general anesthesia may result in anesthetic/analgesic complications in children undergoing surgery, with a risk of impaired mental development. OBJECTIVES: Based on our clinical experience and a literature review, we illustrate the most commonly used analgesic, anesthetic and sedative drugs in pediatric dermatosurgery, and identify risk factors and complications following dermatosurgical procedures...
February 12, 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/29429908/efficacy-of-artisanal-preparations-of-cannabidiol-for-the-treatment-of-epilepsy-practical-experiences-in-a-tertiary-medical-center
#7
Giulia S Porcari, Cary Fu, Emily D Doll, Emma G Carter, Robert P Carson
Medically refractory epilepsy continues to be a challenge worldwide, and despite an increasing number of medical therapies, approximately 1 in 3 patients continues to have seizures. Cannabidiol (CBD), one of many constituents of the Cannabis sativa or marijuana plant, has received renewed interest in the treatment of epilepsy. While highly purified CBD awaits Food and Drug Administration (FDA) approval, artisanal formulations of CBD are readily available and are seeing increased use in our patient population...
February 8, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29429043/treatment-patterns-healthcare-resource-utilization-and-spending-among-medicaid-enrolled-children-with-chronic-idiopathic-spontaneous-urticaria-in-the-united-states
#8
Paul V Williams, Abhishek Kavati, Dominic Pilon, Yongling Xiao, Maryia Zhdanava, Maria-Magdalena Balp, Patrick Lefebvre, Benjamin Ortiz, Vivian Hernandez-Trujillo
INTRODUCTION: Few studies have described chronic idiopathic/spontaneous urticaria (CIU/CSU) healthcare burden in adults, while this information remains largely unknown in children. We aimed to describe treatment patterns, healthcare resource utilization (HRU), and costs in CIU/CSU pediatric patients, as well as to compare HRU and costs in CIU/CSU and CIU/CSU-free pediatric patients. METHODS: Medicaid claims from four states (09/01/2013-03/31/2016) were used to identify patients less than 12 years old...
February 10, 2018: Dermatology and Therapy
https://www.readbyqxmd.com/read/29428899/efficacy-of-lacosamide-in-children-and-adolescents-with-drug-resistant-epilepsy-and-refractory-status-epilepticus-a-systematic-review
#9
REVIEW
Johann Sebastián Ortiz de la Rosa, Lady Diana Ladino, Paula Juliana Rodríguez, María Camila Rueda, Juan Pablo Polanía, Angie Catalina Castañeda
PURPOSE: Lacosamide, is one of the newer antiepileptic drug approved for focal drug-resistant epilepsy as an add-on treatment in patients older than 16 years. However, there is growing evidence of its use, safety and efficacy in children. We aim to evaluate efficacy and tolerability of lacosamide in focal and generalized drug-resistant epilepsy and refractory status epilepticus in the pediatric population. METHODS: We conducted a systematic review on MEDLINE, EMBASE, COCHRANE, Google Scholar and Scielo from January 2008 to January 2017...
February 7, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29413725/current-practices-and-safety-of-medication-use-during-rapid-sequence-intubation
#10
Christine M Groth, Nicole M Acquisto, Tina Khadem
PURPOSE: Characterize medication practices during and immediately after rapid sequence intubation (RSI) by provider/location and evaluate adverse drug events. MATERIALS AND METHODS: This was a multicenter, observational, cross-sectional study of adult and pediatric intensive care unit and emergency department patients over a 24-h period surrounding first intubation. RESULTS: A total of 404 patients from 34 geographically diverse institutions were included (mean age 58 ± 22 years, males 59%, pediatric 8%)...
January 30, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29405671/light-sedation-with-dexmedetomidine-a-practical-approach-for-the-intensivist-in-different-icu-patients
#11
Stefano Romagnoli, Angela Amigoni, Ilaria Blangetti, Giampaolo Casella, Cosimo Chelazzi, Francesco Forfori, Cristiana Garisto, Maria C Mondardini, Marco Moltrasio, Daniela Pasero, Tiziana Principi, Zaccaria Ricci, Fabio Tarantino, Giorgio Conti
Light sedation, corresponding to a Richmond AgitationSedation Scale between 0 and 1 is a priority of modern critical care practice. Dexmedetomidine, a highly selective, central, 2adrenoceptor agonist, is increasingly administered in the intensive care units (ICUs) as an effective drug to induce light sedation, analgesia and a quasiphysiological sleep in critically ill patients. Although in general dexmedetomidine is well tolerated, side effects as bradycardia, hypertension, and hypotension may occur. Although a general dosing range is suggested, different ICU patients may require different and highly precise titration that may significantly vary due to neurological status, cardiorespiratory function, baseline blood pressure, heart rate, liver efficiency, age and coadministration of other sedatives...
February 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29403234/conscious-sedation-with-nitrous-oxide-to-control-stress-during-dental-treatment-in-patients-with-cerebral-palsy-an-experimental-clinical-trial
#12
Fernando M Baeder, Daniel F Silva, Ana Cl de Albuquerque, Maria Tbr Santos
Introduction: Individuals with cerebral palsy (CP) often present with oral alterations that impact oral health and require dental treatment. Aim: This study aimed to evaluate the use of conscious sedation with nitrous oxide (N2O) to control stress during dental treatment in individuals with CP using as parameters: Venham score (VS), heart rate (HR), and respiratory rate (RR). Materials and methods: A total of 77 CP patients >3 years of age with a mean age of 11...
October 2017: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/29395760/shortened-preproceural-fasting-in-the-pediatric-emergency-department
#13
Corrie E Chumpitazi, Elizabeth A Camp, Divya R Bhamidipati, Almea M Montillo, A Chantal Caviness, Lesby Mayorquin, Faria A Pereira
BACKGROUND: There is no evidence of an association between fasting time and the incidence of adverse events during procedural sedation and analgesia. Pediatric and adult emergency medicine guidelines support avoiding delaying procedures based on fasting time. General pediatric guidelines outside emergent care settings continue to be vague and do not support a set fasting period for urgent and emergent procedures. OBJECTIVE: To describe shortened preprocedural fasting and vomiting event rates during the implementation of a shortened fasting protocol...
January 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29390531/dexmedetomidine-based-monitored-conscious-sedation-combined-local-anesthesia-for-levator-resection-in-a-10-year-old-child-with-marcus-gunn-jaw-winking-synkinesis-a-case-report
#14
Ye Tu, Feng Gao
RATIONALE: Levator resection has become a routine procedure for patients with severe Marcus Gunn jaw-winking synkinesis (MGJWS). To optimize the surgical outcome, adult patients need to be kept awake, or easily aroused and responsive to verbal commands during the operation. However, levator resection is commonly performed under general anesthesia in pediatric patients. In the present case, we described a successful anesthetic protocol of conscious sedation with local anesthesia for levator resection in a child...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29386058/teaching-pain-recognition-through-art-the-ramsay-caravaggio-sedation-scale
#15
Federico Poropat, Giorgio Cozzi, Andrea Magnolato, Lorenzo Monasta, Fabio Borrometi, Baruch Krauss, Alessandro Ventura, Egidio Barbi
BACKGROUND: Clinical observation is a key component of medical ability, enabling immediate evaluation of the patient's emotional state and contributing to a clinical clue that leads to final decision making. In medical schools, the art of learning to look can be taught using medical humanities and especially visual arts. By presenting a Ramsay sedation score (RSS) integrated with Caravaggio's paintings during a procedural sedation conference for pediatric residents, we want to test the effectiveness of this approach to improve the quality of learning...
January 31, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29382794/helmet-versus-nasal-prong-cpap-in-infants-with-acute-bronchiolitis
#16
Juan Mayordomo-Colunga, Corsino Rey, Alberto Medina, Pablo Martínez-Camblor, Ana Vivanco-Allende, Andrés Concha
BACKGROUND: Nasal prongs are frequently used to deliver noninvasive CPAP in bronchiolitis, especially in the youngest children. A helmet interface is an alternative that might be comparable to nasal prongs. We sought to compare these interfaces. METHODS: We performed a prospective, randomized, crossover, single-center study in an 8-bed multidisciplinary pediatric ICU in a university hospital. Infants age <3 months who were consecutively admitted to the pediatric ICU during a bronchiolitis epidemic season and fulfilled inclusion criteria were recruited...
January 30, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29377404/sedation-for-magnetic-resonance-imaging-using-propofol-with-or-without-ketamine-at-induction-in-pediatrics-a-prospective-randomized-double-blinded-study
#17
Achim Schmitz, Markus Weiss, Christian Kellenberger, Ruth O Gorman Tuura, Richard Klaghofer, Ianina Scheer, Malek Makki, Carola Sabandal, Philipp Karl Buehler
INTRODUCTION: Deep sedation using propofol has become a standard technique in children. This double-blinded randomized clinical trial aims to compare the clinical effects of propofol-mono-sedation vs a combination of propofol and ketamine at induction and a reduced propofol infusion rate for maintenance in children undergoing diagnostic magnetic resonance imaging. METHODS: Children aged from 3 months to 10 years scheduled as outpatients for elective magnetic resonance imaging with deep sedation were included...
January 27, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29373797/does-extracorporeal-membrane-oxygenation-improve-survival-in-pediatric-acute-respiratory-failure
#18
Ryan P Barbaro, Yuejia Xu, Santiago Borasino, Edward J Truemper, R Scott Watson, Ravi R Thiagarajan, David Wypij, Martha A Q Curley
RATIONALE: Extracorporeal membrane oxygenation (ECMO) has supported gas exchange in children with severe respiratory failure for over 40 years without ECMO efficacy studies. OBJECTIVES: To compare the mortality and functional status of children with severe acute respiratory failure supported with and without ECMO. METHODS: This cohort study compared ECMO-supported children to pair-matched non-ECMO-supported controls with severe acute respiratory distress syndrome (ARDS)...
January 26, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29364490/intranasal-drug-administration-for-procedural-sedation-in-children-admitted-to-pediatric-emergency-room
#19
C Fantacci, G C Fabrizio, P Ferrara, F Franceschi, A Chiaretti
OBJECTIVE: Pain relief is a very important aspect in Pediatrician's clinical practice. It is often thought that young children, particularly infants, do not perceive as much pain as adults because of their immature nervous system and that untreated pain would not have adverse long-term consequences. Instead, it has been demonstrated that infants and children experience pain in a similar manner to adults. Many factors, particularly emotional factors, can increase the child's pain perception...
January 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29363516/the-evolving-role-of-intranasal-dexmedetomidine-for-pediatric-procedural-sedation
#20
Jason Reynolds, Daniel J Sedillo
No abstract text is available yet for this article.
January 23, 2018: Hospital Pediatrics
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