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Paediatric and Anaesthetics

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https://www.readbyqxmd.com/read/29771901/achilles-tenotomy-as-an-office-procedure-and-current-practising-trends-among-new-zealand-orthopaedic-surgeons
#1
Lewis Agius, Angus Wickham, Cameron Walker, Joshua Knudsen
BACKGROUND: Percutaneous Achilles tenotomy (PAT) is performed during the final phase of casting with Ponseti method. Several settings have been proposed as venues for this procedure, however it is increasingly being performed in theatre under a general anaesthetic (GA). General anaesthesia, however, is expensive and not without risks. The purpose of the present study was to compare results of outpatient releases to theatre releases, and assess current practising trends among orthopaedic surgeons...
May 18, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29753606/immunizations-under-sedation-at-a-paediatric-hospital-in-melbourne-australia-from-2012-2016
#2
Daryl R Cheng, Sonja Elia, Kirsten P Perrett
BACKGROUND: Sedation for immunizations is of particular importance in a subset of paediatric patients with anxiety disorders, needle phobia, developmental or behavioural disorders. The Royal Children's Hospital (RCH) Melbourne offers a unique immunization under sedation service for these patients. We aimed to evaluate the number and types of patients using inpatient sedation for immunizations, distraction and sedation techniques used, and outcomes of these procedures. METHODS: A medical record review was conducted on all patients who had immunization under sedation between January 2012 to December 2016 in the RCH Day Medical Unit (DMU)...
May 9, 2018: Vaccine
https://www.readbyqxmd.com/read/29744252/paediatric-vipoma-a-jamboree-of-electrolytes
#3
Amit Rastogi, Vansh Priya, Rudrashish Haldar, Rameez Riaz
Vasoactive intestinal peptide secreting tumour (VIPoma) is a rare type of neuroendocrine tumour (NET), primarily located in the tail of pancreas. This type of tumour presents with myriad of metabolic and electrolyte misbalances in the preoperative period, mainly due to increased vasoactive intestinal peptide (VIP) levels. Perioperative management of patients with VIPoma is challenging, especially when dealing with paediatric patients. The anaesthetic management of a two-year-old girl who was selected for VIPoma resection is hereby presented...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29705730/paediatric-traumatic-cardiac-arrest-a-delphi-study-to-establish-consensus-on-definition-and-management
#4
Annette C Rickard, James Vassallo, Tim Nutbeam, Mark D Lyttle, Ian K Maconochie, Doyo G Enki, Jason E Smith
AIMS: Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients. METHODS: An online Delphi study was conducted over three rounds, with the aim of achieving consensus (defined as 70% agreement) on statements related to the diagnosis and management of paediatric TCA...
April 28, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29701424/perioperative-family-centered-care-nursing-interventions-that-support-child-and-family-s-emotional-management
#5
Dario Antunes, Paula Diogo
INTRODUCTION: Hospitalization is a negative tonality experience for both child and family, being fear and anxiety their emotional mirror. Concerning the surgical experience, the environment, invasiveness, fear of pain, of not waking up from anaesthesia and parental separation are both causes and enhancers of child and family perioperative distress. A study concerning parent's emotional experience of child's submitted to cardiac surgery, refer guilt for their son's cardiopathy, a roller coaster of emotions, impotence and being seated on pins and needles while waiting during the surgery...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699707/anaesthetic-management-of-a-paediatric-patient-with-congenital-fibre-type-disproportion-myopathy
#6
F Buisán, O de la Varga, M Flores, J Sánchez-Ruano
Congenital fibre type disproportion (CFTD) is a rare type of myopathy that is characterised by muscle weakness and hypotonia during childhood. Clinical features include motor delay, feeding difficulties, limb weakness, joint contractures, and scoliosis. A report is presented of the anaesthetic management of a 3-year-old girl with CFTD myopathy associated with a mutation of the TPM3 gene, scheduled for adenotonsillectomy because of obstructive sleep apnoea hypopnoea syndrome (OSAHS). The main concerns were the possible susceptibility to malignant hyperthermia, the risk of anaesthesia-induced rhabdomyolysis, a greater sensitivity to non-depolarising muscle relaxants, and the presence of OSAHS...
April 23, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29666130/does-dexmedetomidine-given-as-a-premedication-or-intraoperatively-reduce-post-hospitalisation-behaviour-change-in-children-a-study-protocol-for-a-randomised-controlled-trial-in-a-tertiary-paediatric-hospital
#7
Paul Lee-Archer, Craig McBride, Rebecca Paterson, Michael Reade, Britta Regli-von Ungern-Sternberg, Deborah Long
INTRODUCTION: It has been reported that post-hospitalisation behaviour change (PHBC) occurs in over 50% of children undergoing a general anaesthetic and manifests as behaviours such as sleep and eating disorders, defiance of authority, nightmares, enuresis and temper tantrums. The effect is usually short-lived (2-4 weeks); however, in 5-10% of children, these behaviours can last up to 12 months. The risk factors for developing PHBC include underlying anxiety in the child or parent, a previous bad hospital experience, emergence delirium and preschool age...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29661242/use-applicability-and-reliability-of-depth-of-hypnosis-monitors-in-children-a-survey-among-members-of-the-european-society-for-paediatric-anaesthesiology
#8
Yuen Man Cheung, Gail Scoones, Robert Jan Stolker, Frank Weber
BACKGROUND: To assess the thoughts of practicing anaesthesiologists about the use of depth of hypnosis monitors in children. METHODS: Members of the European Society for Paediatric Anaesthesiology were invited to participate in an online survey about their thoughts regarding the use, applicability and reliability of hypnosis monitoring in children. RESULTS: The survey achieved a response rate of 30% (N = 168). A total of 138 completed surveys were included for further analysis...
April 16, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29643549/low-flow-anaesthesia-underused-mode-towards-sustainable-anaesthesia
#9
REVIEW
Madhusudan Upadya, P J Saneesh
Any technique that employs a fresh gas flow that is less than the alveolar ventilation can be classified as low-flow anaesthesia. The complexities involved in the calculation of uptake of anaesthetic agents during the closed-circuit anaesthesia made this technique less popular. However, the awareness of the dangers of theatre pollution with trace amounts of the anaesthetic agents and the prohibitively high cost of the new inhalational agents, have helped in the rediscovery of low-flow anaesthesia. Moreover, the time has arrived for each of us, the practicing anaesthesiologists, to move towards the practice of low-flow anaesthesia, to achieve lesser theatre and environmental pollution and also to make anaesthesia more economical...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29576117/a-neurosteroid-analogue-with-t-type-calcium-channel-blocking-properties-is-an-effective-hypnotic-but-is-not-harmful-to-neonatal-rat-brain
#10
N Atluri, S M Joksimovic, A Oklopcic, D Milanovic, J Klawitter, P Eggan, K Krishnan, D F Covey, S M Todorovic, V Jevtovic-Todorovic
BACKGROUND: More than 4 million children are exposed annually to sedatives and general anaesthetics (GAs) in the USA alone. Recent data suggest that common GAs can be detrimental to brain development causing neurodegeneration and long-term cognitive impairments. Challenged by a recent US Food and Drug Administration (FDA) warning about potentially neurotoxic effects of GAs in children, there is an urgent need to develop safer GAs. METHODS: Postnatal Day 7 (P7) rat pups of both sexes were exposed to six (repeated every 2 h) injections of equipotent hypnotic doses of ketamine or the neuroactive steroid (3β,5β,17β)-3-hydroxyandrostane-17-carbonitrile (3β-OH) for 12 h...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29569452/single-tooth-anaesthesia-a-new-approach-to-the-paediatric-patient-a-clinical-experimental-study
#11
L Giannetti, E Forabosco, E Spinas, D Re, A Murri Dello Diago
AIM: The objective of this study is to assess the efficacy of the STA Wand System with respect to pain and fear reduction in paediatric patients and by using the Single Tooth Anaesthesia (STA) technique. MATERIALS AND METHODS: Patients included children and teenagers between 6 and 17 years of age, who required the administration of local anaesthesia prior to expected treatments. Local anaesthesia was performed by means of the electronic STA Wand System (Milestone scientific...
March 2018: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/29564214/use-of-ketamine-sedation-for-the-management-of-displaced-paediatric-forearm-fractures
#12
Anatole Vilhelm Wiik, Poonam Patel, Joanna Bovis, Adele Cowper, Philip Socrates Pastides, Alison Hulme, Stuart Evans, Charles Stewart
AIM: To determine if ketamine sedation is a safe and cost effective way of treating displaced paediatric radial and ulna fractures in the emergency department. METHODS: Following an agreed interdepartmental protocol, fractures of the radius and ulna (moderately to severely displaced) in children between the age of 2 and 16 years old, presenting within a specified 4 mo period, were manipulated in our paediatric emergency department. Verbal and written consent was obtained prior to procedural sedation to ensure parents were informed and satisfied to have ketamine...
March 18, 2018: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29522148/dexmedetomidine-improves-the-outcomes-in-paediatric-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#13
Yang Liu, Weishuai Bian, Ping Liu, Xuefeng Zang, Xuyun Gu, Wei Chen
OBJECTIVES: Dexmedetomidine has been shown to decrease cardiac complications in adults undergoing cardiac surgery. Results from clinical trials of dexmedetomidine on outcomes following paediatric cardiac surgery are controversial. METHODS: We searched EMBASE, PubMed and Cochrane CENTRAL databases for randomized controlled trials comparing the effect of dexmedetomidine versus placebo or other anaesthetic drugs in paediatric patients undergoing cardiac surgery. The primary outcome was the duration of mechanical ventilation...
May 1, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29491526/paediatric-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-anaesthetic-and-procedural-considerations
#14
Saurabh Mittal, Sachidanand Jee Bharati, Sushil K Kabra, Karan Madan
No abstract text is available yet for this article.
February 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29463325/paediatric-obstructive-sleep-apnoea-is-our-operative-management-evidence-based
#15
L Pabla, J Duffin, L Flood, K Blackmore
BACKGROUND: Despite the plethora of publications on the subject of paediatric obstructive sleep apnoea, there seems to be wide variability in the literature and in practice, regarding recourse to surgery, the operation chosen, the benefits gained and post-operative management. This may reflect a lack of high-level evidence. METHODS: A systematic review of four significant controversies in paediatric ENT was conducted from the available literature: tonsillectomy versus tonsillotomy, focusing on the evidence base for each; anaesthetic considerations in paediatric obstructive sleep apnoea surgery; the objective evidence for the benefits of surgical treatment for obstructive sleep apnoea; and the medical treatment options for residual obstructive sleep apnoea after surgical treatment...
April 2018: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29452813/incidence-characteristics-and-predictive-factors-for-medication-errors-in-paediatric-anaesthesia-a-prospective-incident-monitoring-study
#16
C Gariel, B Cogniat, F-P Desgranges, D Chassard, L Bouvet
BACKGROUND: Medication errors are not uncommon in hospitalized patients. Paediatric patients may have increased risk for medication errors related to complexity of weight-based dosing calculations or problems with drug preparation and dilution. This study aimed to determine the incidence of medication errors in paediatric anaesthesia in a university paediatric hospital, and to identify their characteristics and potential predictive factors. METHODS: This prospective incident monitoring study was conducted between November 2015 and January 2016 in an exclusively paediatric surgical centre...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29422576/neighbourhood-incidence-rate-of-paediatric-dental-extractions-under-general-anaesthetic-in-south-west-england
#17
P J Lucas, D Patsios, K Walls, P Neville, P Harwood, J G Williams, J Sandy
Introduction Extraction of decayed teeth is the most common reason for UK children aged 5-9 years to receive a general anaesthetic. Inequalities in oral health are well recognised, but is under-explored in dental general anaesthesia (DGA).Methods Secondary analysis of routinely collected data from three local authorities in South West England was used to assess: 1) dental activities recorded for children <18 years attending NHS general dental practitioners (GDP); 2) the incidence rate of DGA and disease severity among <16-year-olds; and 3) individual and neighbourhood factors associated with higher rates of child DGA, and greater severity of disease...
February 9, 2018: British Dental Journal
https://www.readbyqxmd.com/read/29416155/erector-spinae-plane-block-as-an-alternative-to-epidural-analgesia-for-post-operative-analgesia-following-video-assisted-thoracoscopic-surgery-a-case-study-and-a-literature-review-on-the-spread-of-local-anaesthetic-in-the-erector-spinae-plane
#18
Sanjib Das Adhikary, Ashlee Pruett, Mauricio Forero, Venkatesan Thiruvenkatarajan
Post-operative pain after minimally invasive video-assisted thoracoscopic surgery (VATS) in adults is commonly managed with oral and parenteral opioids and invasive regional techniques such as thoracic epidural blockade. Emerging research has shown that the novel erector spinae plane (ESP) block, can be employed as a simple and safe alternative analgesic technique for acute post-surgical, post-traumatic and chronic neuropathic thoracic pain in adults. We illustrate this by presenting a paediatric case of VATS, in which an ESP block provided better analgesia, due to greater dermatomal coverage, as well as reduced side-effects when compared with a thoracic epidural that had previously been employed on the same patient for a similar procedure on the opposite side...
January 2018: Indian Journal of 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
#19
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/29398196/monitoring-of-optic-nerve-function-in-neurofibromatosis-2-children-with-optic-nerve-sheath-meningiomas-using-multifocal-visual-evoked-potentials
#20
V Jayanetti, A I Klistorner, S L Graham, M Dexter, M P Flaherty, K Jones, F A Billson, M Wilson, K North, J R Grigg, C L Fraser
Monitoring optic nerve sheath meningiomas (ONSM) in Neurofibromatosis type 2 (NF2) patients remains difficult. Other ocular manifestations of NF2 may obscure ophthalmic assessment of optic nerve function in these patients. Serial magnetic resonance imaging (MRI) used to assess the optic nerve is not without limitations, being expensive and often requiring general anaesthetic in children, with associated risks. This study was undertaken to describe the use of multifocal visual evoked potentials (multifocal VEP, mfVEP) in the regular monitoring of NF2 patients with ONSM...
April 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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