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Management pediatric anesthesia

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https://www.readbyqxmd.com/read/29750630/esophageal-atresia-with-tracheoesophageal-fistula-and-gastroesophageal-reflux-in-children-dental-considerations-and-case-report
#1
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/29746281/aesthetic-unit-boundary-approach-of-large-fibroadenoma-resection
#2
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/29728260/anesthesia-in-a-pediatric-patient-with-rohadd-syndrome
#3
E Esparza Isasa, M A Palomero Rodríguez, I Acebedo Bambaren, C Medrano Viñas, D Gil Mayo, F Domínguez Pérez, D Pestaña Lagunas
Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome is a rare entity that is characterised by its onset in healthy children at 2-4 years of age. It is a complex syndrome that includes, among other symptoms, rapid weight gain with hyperphagia, hypothalamic dysfunction, central hypoventilation, and autonomic dysregulation. The case is presented of a 10-year-old boy with a diagnosis of ROHHAD syndrome undergoing insertion of a port-a-cath under general anaesthesia, who developed complications during the anaesthetic procedure related to his illness...
May 1, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29714490/efficacy-of-ketamine-in-pediatric-sedation-dentistry-a-systematic-review
#4
Samuel Oh, Karl Kingsley
BACKGROUND: Ketamine has been used as a safe and effective sedative to treat adults and children exhibiting high levels of anxiety or fear during dental treatment. Pediatric dentistry often involves patients with high levels of anxiety and fear and possibly few positive dental experiences. Patient management can involve behavioral approaches, as well as the use of sedation or general anesthesia with a variety of agents, including midazolam, diazepam, hydroxyzine, meperidine, and ketamine...
May 2018: Compendium of Continuing Education in Dentistry
https://www.readbyqxmd.com/read/29709387/the-fork-in-the-road-a-laryngeal-filter-airway-foreign-body
#5
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...
April 18, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29700894/consensus-statement-on-clear-fluids-fasting-for-elective-pediatirc-general-anesthesia
#6
Mark Thomas, Christa Morrison, Richard Newton, Ehrenfried Schindler
Pediatric anesthetic guidelines for the management of preoperative fasting of clear fluids are currently 2 hours. The traditional 2 hours clear fluid fasting time was recommended to decrease the risk of pulmonary aspiration and is not in keeping with current literature. It appears that a liberalized clear fluid fasting regime does not affect the incidence of pulmonary aspiration and in those who do aspirate, the sequelae are not usually severe or long-lasting. With a 2-hour clear fasting policy, the literature suggests that this translates into 6-7 hours actual duration of fasting with several studies up to 15 hours...
April 27, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29697466/perioperative-considerations-for-airway-management-and-drug-dosing-in-obese-children
#7
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/29687529/lymphatic-imaging-and-intervention-in-a-pediatric-population-anesthetic-considerations
#8
David R Jobes, Lauren A Brown, Yoav Dori, Maxim Itkin, Susan C Nicolson
The recent adoption of an improved lymphatic access technique coupled with Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography has introduced the ability to diagnose and treat severe lymphatic disorders unresponsive to other therapies. All pediatric patients presenting for lymphatic procedures require general anesthesia presenting challenges in managing highly morbid and comorbid conditions both from logistical as well as medical aspects. General anesthesia is used because of the procedural requirement for immobility to accurately place needles and catheters, treat pain secondary to contrast and glue injections, and to accommodate additional procedures...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29687523/safety-of-anesthesia-for-children-with-mucopolysaccharidoses-a-retrospective-analysis-of-54-patients
#9
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...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29664508/oral-self-mutilation-in-lesch-nyhan-syndrome-case-report
#10
Andrés Campolo González, Alex Vargas Díaz, Daniel Fontboté Riesco, Marta Hernández Chávez
INTRODUCTION: Lesch-Nyhan syndrome (LNS) is an inherited recessive X-related disorder caused by the deficiency of the enzyme hypoxanthin-guanine phosphorribosyl transferase (HPRT). Compul sive self-mutilation and dystonia occurs before the first year of age and is expressed by persistent bites on the oral mucosa, lips, tongue, fingers, and shoulders. The dental intervention performed on most of these patients is multiple tooth extraction to prevent serious secondary lesions. OBJECTIVE: To present a clinical case of LNS and describe pediatric dentistry management in patients with self-mutilating behavior...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29661575/outcomes-of-laparoscopic-resection-of-meckel-s-diverticulum-are-equivalent-to-open-laparotomy
#11
Brian Ezekian, Harold J Leraas, Brian R Englum, Brian F Gilmore, Christopher Reed, Tamara N Fitzgerald, Henry E Rice, Elisabeth T Tracy
PURPOSE: Meckel's diverticulum (MD) is a common congenital anomaly caused by failure of involution of the omphalomesenteric duct. Enthusiasm for minimally invasive surgery (MIS) in children has burgeoned as technologies have advanced, but the outcomes of laparoscopic resection in comparison to open laparotomy for MD remain poorly defined. We queried a large national database to compare current practice patterns and clinical outcomes between surgical approaches for MD in the pediatric population...
March 15, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29661126/gnao1-mutation-induced-pediatric-dystonic-storm-rescue-with-pallidal-deep-brain-stimulation
#12
C Michael Honey, Armaan K Malhotra, Maja Tarailo-Graovac, Clara D M van Karnebeek, Gabriella Horvath, Adi Sulistyanto
Dystonic storm or status dystonicus is a life-threatening hyperkinetic movement disorder with biochemical alterations due to the excessive muscle contractions. The medical management can require pediatric intensive care unit admission and a combination of medications while the underlying trigger is managed. Severe cases may require general anesthesia and paralytic agents with intubation and may relapse when these drugs are weaned. Deep brain stimulation of the globus pallidum has been reported to terminate dystonic storm in several pediatric cases...
May 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29643628/pediatric-critical-incidents-reported-over-15-years-at-a-tertiary-care-teaching-hospital-of-a-developing-country
#13
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/29628848/wilm-s-tumor-with-intracardiac-extension-causing-dynamic-tricuspid-valve-obstruction-an-anesthetic-challenge
#14
Kamal Kajal, Ganesh Kumar Munirathinam, Banashree Mandal, Komal Gandhi, Harkant Singh, Ravi Kanojia
Wilms' tumor (WT) is the most common pediatric renal tumor that often spreads to inferior vena cava and sometimes up to right atrium (RA). We describe successful management of 3-year-old child diagnosed with WT having extension up to RA. He was operated under cardiopulmonary bypass and extubated on postoperative day 2 and discharged. Perioperative anesthesia concerns were shock from dynamic tricuspid valve obstruction, intraoperative massive blood loss, and a higher risk of pulmonary thromboembolism during tumor manipulation...
April 2018: Saudi Journal of Anaesthesia
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/29628597/anesthetic-management-in-pediatric-patient-for-percutaneous-endoscopic-gastrostomy-with-mitochondrial-myopathy-leigh-syndrome
#16
Ebru Tarikçi Kiliç, Nelgin Gerenli, Mehmet Salim Akdemir, Necmi Onur Tastan, Egemen Atag
Leigh syndrome (LS) is a rare disease mainly affecting the central nervous system due to the abnormalities of mitochondrial energy generation and seen in early childhood with progressive loss of movement, mental abilities, seizures, nystagmus, ophthalmoparesis, optic atrophy, ataxia, dystonia, or respiratory failure. Anesthesia and surgery exacerbate the risks of aspiration, wheezing, and breathing difficulties. Tracheal irritability can be stimulated with the efforts of intubation. We report the anesthetic management of a rare case of an 11-year-old boy with a severe form of LS for percutaneous endoscopic gastrostomy insertion...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29622311/anesthesia-for-the-pediatric-oral-and-maxillofacial-surgery-patient
#17
REVIEW
Deepak G Krishnan
Pediatric patients present to the oral and maxillofacial surgeon for surgical services that can be performed safely and efficiently. Children and parents tend to be anxious; achieving cooperation is paramount for successful procedures. Several techniques can be used to alleviate anxiety and provide analgesia and anesthesia. This article outlines the anatomy and physiology of children and the preoperative anesthetic preparation and techniques unique to pediatric anesthesia. It discusses standards in training in pediatric anesthesia and current recommendations for monitoring...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
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
#18
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/29603705/comparison-of-visual-analog-scale-scores-in-pain-assessment-during-pulpotomy-using-different-injection-materials-in-children-aged-6-to-8-and-8-to-10-years
#19
Donya Alinejhad, Zahra Bahrololoomi, Alireza Navabazam, M Ali Asayesh
AIM: Proper anesthesia and pain management during treatment are most important concerns in dentistry for people of all ages, especially children. This study compared the success rate of lidocaine block with articaine buccal infiltration during anesthesia of the primary mandibular second molars in children aged 6 to 8 and 8 to 10 years. MATERIALS AND METHODS: The present clinical trial was conducted on 40 children aged 6 to 8 and 8 to 10 years who were referred to the Department of Pediatrics of the Faculty of Dentistry at Shahid Sadoughi University of Medical Sciences in Yazd (Islamic Republic of Iran) and needed to be treated with pulpotomy on both primary mandibular second molars...
March 1, 2018: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/29557595/complications-during-esophageal-endoscopy-with-or-without-baloon-dilation-under-general-anesthesia-in-pediatric-patients-a-prospective-and-observational-study
#20
Pinar Kendigelen, Ayse C Tutuncu, Senol Emre, Fatis Altindas, Guner Kaya
BACKGROUND: Complications can occur during esophagoscopy as a result of applied procedure in children, especially during dilation techic. Our aim was to identify cardio-respiratory alterations during esophagoscopy with or without baloon dilation under anesthesia in children, and to investigate the postoperative complications. METHODS: Prospective, observational study of endoscopic procedures in patients 0-16 years. The patients were divided into two groups: the endoscopy-dilation group (Group ED: endoscopy and balloon dilation due to esophageal stricture) and endoscopy without dilation (Group E: endoscopy for diagnostic reasons, control esophagoscopy or sclerotherapy)...
April 1, 2018: Archivos Argentinos de Pediatría
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