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Paediatric and Anaesthetics

Alain Chichom-Mefire, Victor Mbome Njie, Vincent Verla, Julius Atashili
BACKGROUND: Surgery-related conditions account for the majority of admissions in primary referral hospitals in Sub-Saharan Africa. The role of surgery in the reduction of global disease burden is well recognized, but there is a great qualitative and quantitative disparity in the delivery of surgical and anaesthetic services between countries. This study aims at estimating the nature and volume of surgery delivered in an entire administrative division of Cameroon. METHODS: In this retrospective survey conducted during the year 2013, we used a standard tool to analyse the infrastructure and human resources involved in the delivery of surgical and anaesthetic services in the Fako division in the south-west region of Cameroon...
October 24, 2016: World Journal of Surgery
James K Hamill, Jamie-Lee Rahiri, Gamage Gunaratna, Andrew G Hill
BACKGROUND: No enhanced recovery after surgery protocol has been published for laparoscopic appendectomy. This was a review of evidence-based interventions that could optimize recovery after appendectomy. METHODS: Interventions for the review Clinical pathway, fast-track or enhanced recovery protocols; needlescopic approach; single incision laparoscopic (SIL) approach; natural orifice transluminal endoscopic surgery (NOTES); regional nerve blocks; intraperitoneal local anaesthetic (IPLA); drains...
October 17, 2016: Surgical Endoscopy
K Cox, A Kyriakou, B Amjad, S O'Toole, M E Flett, M Welsh, S F Ahmed, S Cascio
INTRODUCTION: Anogenital distance (AGD) is a recognised marker of in utero androgen action. OBJECTIVE: This study aimed to evaluate the relationship between severity of hypospadias and AGD. STUDY DESIGN: Boys undergoing hypospadias repair in a single tertiary centre between May 2012 and February 16 were included in the study. Anogenital distance was measured from the centre of the anus to the base of the penis, and anoscrotal distance (ASD) from the centre of the anus to the junction between the smooth perineal skin and scrotal skin...
September 9, 2016: Journal of Pediatric Urology
J M Huitink, P P Lie, I Heideman, E P Jansma, R Greif, N van Schagen, A Schauer
The aim of this study was to develop an audit tool to identify prospectively all peri-operative adverse events during airway management in a cost-effective and reproducible way. All patients at VU University Medical Center who required general anaesthesia for elective and emergency surgical procedures were included during a period of 8 weeks. Daily questionnaires and interviews were taken from anaesthesia trainees and anaesthetic department staff members. A total of 2803 patients underwent general anaesthesia, 1384 men and 1419 women, including 2232 elective patients and 571 emergency procedures, 697 paediatric and 2106 adult surgical procedures...
September 26, 2016: Anaesthesia
Sean Copson, Katrina Calvert, Puvaneswary Raman, Elizabeth Nathan, Mathias Epee
BACKGROUND: Cord prolapse is an uncommon obstetric emergency, with potentially fatal consequences for the baby if prompt action is not taken. Simulation training provides a means by which uncommon emergencies can be practised, with the aim of improving teamwork and clinical outcomes. AIMS: This study aimed to determine if the introduction of a simulation-based training course was associated with an improvement in the management of cord prolapse, in particular the diagnosis to delivery interval...
September 7, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Michael A Glasby, Athanasios I Tsirikos, Lindsay Henderson, Gillian Horsburgh, Brian Jordan, Ciara Michaelson, Christopher I Adams, Enrique Garrido
PURPOSE: To compare measurements of motor evoked potential latency stimulated either magnetically (mMEP) or electrically (eMEP) and central motor conduction time (CMCT) made pre-operatively in conscious patients using transcranial and intra-operatively using electrical cortical stimulation before and after successful instrumentation for the treatment of adolescent idiopathic scoliosis. METHODS: A group initially of 51 patients with adolescent idiopathic scoliosis aged 12-19 years was evaluated pre-operatively in the outpatients' department with transcranial magnetic stimulation...
August 23, 2016: European Spine Journal
E Béquignon, N Teissier, A Gauthier, L Brugel, H De Kermadec, A Coste, V Prulière-Escabasse
OBJECTIVE: The aim of this review is to determine an efficient and safe primary strategy care for paediatric epistaxis. DATA SOURCES: We searched PubMed and Cochrane databases for studies referenced with key words 'epistaxis AND childhood'. This search yielded 32 research articles about primary care in childhood epistaxis (from 1989 to 2015). Bibliographic references found in these articles were also examined to identify pertinent literature. We compared our results to the specific management of adult epistaxis classically described in the literature...
August 19, 2016: Emergency Medicine Journal: EMJ
Christian Bergamini, Noah Moruzzi, Francesco Volta, Laura Faccioli, Jantje Gerdes, Maria Cristina Mondardini, Romana Fato
Propofol (2,6-diisopropylphenol) is an anaesthetic widely used for human sedation. Due to its intrinsic antioxidant properties, rapid induction of anaesthesia and fast recovery, it is employed in paediatric anaesthesia and in the intensive care of premature infants. Recent studies have pointed out that exposure to anaesthesia in the early stage of life might be responsible of long-lasting cognitive impairment. The apoptotic neurodegeneration induced by general anaesthetics (GA) involves mitochondrial impairment due to the inhibition of the OXPHOS machinery...
August 2016: Journal of Bioenergetics and Biomembranes
Paul F Ashley, Susan Parekh, David R Moles, Prabhleen Anand, Laura C I MacDonald
BACKGROUND: Fear of dental pain is a major barrier to treatment for children who need dental care. The use of preoperative analgesics has the potential to reduce postoperative discomfort and intraoperative pain. We reviewed the available evidence to determine whether further research is warranted and to inform the development of prescribing guidelines. This is an update of a Cochrane review published in 2012. OBJECTIVES: To assess the effects of preoperative analgesics for intraoperative or postoperative pain relief (or both) in children and adolescents undergoing dental treatment without general anaesthesia or sedation...
2016: Cochrane Database of Systematic Reviews
Christopher Chiswell, Yasmin Akram
BACKGROUND: Tobacco smoke exposure in adults is linked to adverse anaesthetic and surgical outcomes. Environmental tobacco smoke (ETS) exposure, including passive smoking, causes a number of known harms in children, but there is no established evidence review on its impact on intraoperative and postoperative outcomes. OBJECTIVES: To undertake a systematic review of the impact of ETS on the paediatric surgical pathway and to establish if there is evidence of anaesthetic, intraoperative and postoperative harm...
July 14, 2016: Archives of Disease in Childhood
M Alonso, L Builes, P Morán, A Ortega, E Fernández, F Reinoso-Barbero
BACKGROUND: Desflurane has been used in paediatric patients for several surgical indications. This article analyses the efficacy and safety of desflurane for diagnostic-therapeutic procedures in remote areas far from operating room in a group of selected patients with no known associated respiratory disease. MATERIAL AND METHODS: A retrospective analysis was performed on 2,072 general anaesthesia procedures stored in a computer database, in which desflurane was used in a Paediatric Pain Unit during the years 2013 and 2014...
July 2, 2016: Revista Española de Anestesiología y Reanimación
Ahmet Selim Özkan, Mehmet Ali Erdoğan, Mukadder Şanlı, Osman Kaçmaz, Mahmut Durmuş, Cemil Çolak
OBJECTIVE: Most dental procedures can be performed with local anaesthesia, however noncompliant paediatric patients, patients with mental retardation or psychiatric disorders, severe anxiety, severe craniofacial anomalies and orofacial trauma may need general anaesthesia. In these patients accompanying central nervous system diseases and airway problems increase the risk of complications. Anaesthesia records of 467 cases of dental surgery performed under general anaesthesia between 2011-2014 is reported with information from the recent literature...
October 2015: Turkish Journal of Anaesthesiology and Reanimation
Christine Kubulus, Kathrin Schmitt, Noemi Albert, Alexander Raddatz, Stefan Gräber, Paul Kessler, Thorsten Steinfeldt, Thomas Standl, André Gottschalk, Winfried Meissner, Stefan P Wirtz, Jürgen Birnbaum, Jan Stork, Thomas Volk, Hagen Bomberg
BACKGROUND: Whether adults should be awake, sedated or anaesthetised during establishment of regional anaesthesia is still debated and there is little information on the relative safety of each. In paediatric practice, there is often little choice but to use sedation or anaesthesia as otherwise the procedures would be too distressing and patient movement would be hazardous. OBJECTIVE(S): The objective of this study was to evaluate complications related to central and peripheral regional block and patient satisfaction in awake, sedated and anaesthetised adult patients...
October 2016: European Journal of Anaesthesiology
James Jackson Mulvany, Andrew Weatherall, Amanda Charlton, Hiran Selvadurai
Congenital lobar emphysema (CLE), a rare condition that usually presents in the neonatal period, can be a diagnostic and therapeutic challenge for the treating clinician. If unrecognised, it is a significant risk at the time of anaesthetic induction. We describe a case of CLE in a 3-month-old boy who was initially treated for suspected aspiration pneumonia at the referring hospital. We highlight the importance of careful consideration of common childhood respiratory illness as well as pneumothorax in the differential diagnosis, and the significance of appropriate preoperative anaesthetic management...
2016: BMJ Case Reports
Kolathu Parambil Radhika, Melveetil S Sreejit, Konnanath T Ramadas
BACKGROUND AND AIMS: The perioperative behavioural studies demonstrate that children are at greater risk of experiencing turbulent anaesthetic induction and adverse behavioural sequelae. We aimed to compare the efficacy of midazolam 0.5 mg/kg with triclofos sodium 100 mg/kg as oral premedication in children undergoing elective surgery. METHODS: In this prospective, randomised and double-blind study, sixty children posted for elective lower abdominal surgery were enrolled...
June 2016: Indian Journal of Anaesthesia
Anna Rosati, Lucrezia Ilvento, Manuela L'Erario, Salvatore De Masi, Annibale Biggeri, Giancarlo Fabbro, Roberto Bianchi, Francesca Stoppa, Lucia Fusco, Silvia Pulitanò, Domenica Battaglia, Andrea Pettenazzo, Stefano Sartori, Paolo Biban, Elena Fontana, Elisabetta Cesaroni, Donatella Mora, Paola Costa, Rosanna Meleleo, Roberta Vittorini, Alessandra Conio, Andrea Wolfler, Massimo Mastrangelo, Maria Cristina Mondardini, Emilio Franzoni, Kathleen S McGreevy, Lorena Di Simone, Alessandra Pugi, Lorenzo Mirabile, Federico Vigevano, Renzo Guerrini
INTRODUCTION: Status epilepticus (SE) is a life-threatening neurological emergency. SE lasting longer than 120 min and not responding to first-line and second-line antiepileptic drugs is defined as 'refractory' (RCSE) and requires intensive care unit treatment. There is currently neither evidence nor consensus to guide either the optimal choice of therapy or treatment goals for RCSE, which is generally treated with coma induction using conventional anaesthetics (high dose midazolam, thiopental and/or propofol)...
2016: BMJ Open
Nick Lipley
No abstract text is available yet for this article.
June 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
J Herzog-Niescery, P Gude, F Gahlen, H-M Seipp, H Bartz, N M Botteck, M Bellgardt, S Dazert, T P Weber, H Vogelsang
Although sevoflurane is commonly used in anaesthesia, a threshold value for maximum exposure to personnel does not exist and although anaesthetists are aware of the problem, surgeons rarely focus on it. We used a photo-acoustic infrared device to measure the exposure of surgeons to sevoflurane during paediatric adenoidectomies. Sixty children were randomly allocated to laryngeal mask, cuffed tracheal tube or uncuffed tracheal tube. The average mean (maximum) sevoflurane concentrations within the surgeons' operating area were 1...
August 2016: Anaesthesia
Girish Chikkanayakanahalli Narasimhamurthy, Muralidhara Danappa Patel, Yvonne Menezes, Kavyashree Nagenahalli Gurushanth
INTRODUCTION: Ropivacaine is amide local anaesthetic pure S(-)enantiomer of bupivacaine. Its duration of analgesia is similar to that of Bupivacaine (in equivalent doses) but the motor block is slower in onset, less intense, shorter in duration for a given level of sensory block with lesser cardiac side effects but addition of an adjuvant like clonidine which is an imidazoline derivative has been studied for its sedative, anxiolytic and analgesic properties. AIM: This study was aimed to show the optimum concentrations of Ropivacaine and Clonidine to maximize analgesia without side effects by evaluating its safety and efficacy...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Rachel Easto, Rishi Shukla, Charlie Rowland, Richard Williams
Paediatric grommet insertions are a common ENT procedure which is typically carried out as a daycase procedure. National guidelines exist (NICE CG60) outlining the criteria for grommet insertions. At our institution it was noted that children were experiencing long waits for their grommet surgery with 78% breaching the national 18 week RTT target by time of surgery in the preceding 6 months. 38% of children were attending for surgery with out of date audiograms and as a consequence, due to children no longer meeting the NICE criteria for grommet insertions, 8% of children were being cancelled on the day of surgery...
2016: BMJ Quality Improvement Reports
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