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Management pediatric anesthesia

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https://www.readbyqxmd.com/read/27922569/mode-of-information-delivery-does-not-effect-anesthesia-trainee-performance-during-simulated-perioperative-pediatric-critical-events-a-trial-of-paper-versus-electronic-cognitive-aids
#1
Scott C Watkins, Shilo Anders, Anna Clebone, Elisabeth Hughes, Vikram Patel, Laura Zeigler, Yaping Shi, Matthew S Shotwell, Matthew D McEvoy, Matthew B Weinger
INTRODUCTION: Cognitive aids (CAs), including emergency manuals and checklists, have been recommended as a means to address the failure of healthcare providers to adhere to evidence-based standards of treatment during crisis situations. Unfortunately, users of CAs still commit errors, omit critical steps, fail to achieve perfect adherence to guidelines, and frequently choose to not use CA during both simulated and real crisis events. We sought to evaluate whether the mode in which a CA presents information (ie, paper vs...
December 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/27912973/micro-ureteroscopy-for-the-treatment-of-distal-ureteral-calculi-in-children
#2
Mehmet Mazhar Utanğaç, Ahmet Ali Sancaktutar, Abdulkadir Tepeler
OBJECTIVE: The objective of this study was to demonstrate the efficacy and safety of micro-ureteroscopy (micro-URS) in the management of distal ureteral stones in the pediatric population. MATERIALS AND METHODS: A total of 11 children, who had undergone micro-URS between September 2015 and April 2016 with the indication of distal ureteral calculi in two referral centers, were retrospectively evaluated. The procedures were performed with the patient in the lithotomy position under general anesthesia using the standard URS technique with a micro-ureteroscope that has a caliber of 4...
November 17, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27910175/postanesthesia-evaluation-of-emotional-and-psychological-satisfaction-in-a-hispanic-population
#3
Angela Zauner, Alvaro Pinilla, Daniel Benitez, Alejandra Tellez, David Romero, Ana Suarez, Vanessa López, Eduardo Hermida
BACKGROUND: Patient satisfaction has a positive impact on clinical care. Different strategies, such as questionnaires, have been developed to evaluate and improve patient satisfaction. A validated pediatric anesthesia questionnaire previously showed the importance of perioperative care built upon a relationship of trust between healthcare providers and children and parents, and a comfortable environment in which satisfactory answers are provided. However, the questionnaire was validated in English, and no research exists on the use of satisfaction questionnaires in Spanish...
December 2, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27894430/anesthesia-for-common-pediatric-emergency-surgeries
#4
REVIEW
Matthew C Mitchell, Ibrahim Farid
Anesthesiologist must be prepared on a daily basis to care for children who need emergency surgery. An appropriate perioperative plan must be formulated and executed to ensure successful management of the child. This article outlines how to prepare and effectively manage common pediatric emergency surgeries.
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27893572/pain-management-in-pediatric-burn-patients-review-of-recent-literature-and-future-directions
#5
Omar Pardesi, Gennadiy Fuzaylov
Childhood burns are a profoundly traumatic and painful experience. Despite recognition of the prevalence of burn injuries in children and the severity of the associated pain, burn pain remains undertreated. At the same time, more evidence is emerging to suggest that undertreated pain has serious long-term medical and psychiatric consequences, many of which can be ameliorated with improved pain control. Pain in burn patients is, however, notoriously difficult to treat, perhaps because there is a chronic pain aspect underlying the acute pain that accompanies wound care and procedures...
November 17, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27890061/preoperative-screening-for-sleep-disordered-breathing-in-children-a-systematic-literature-review
#6
Erin E Bauer, Rebecca Lee, Yasmine N Campbell
Clinicians frequently underestimate or do not assess sleep-disordered breathing (SDB) in children in ambulatory surgical centers. Identifying the disorder and obtaining information relevant to anesthesia management can be assisted by the use of a standard questionnaire during preoperative assessment. We wanted to determine whether a preoperative screening tool increases clinician awareness of SDB in children and leads to a decrease in perioperative respiratory adverse events. We reviewed 21 articles to identify reliable screening tools for pediatric SDB in ambulatory surgical centers and selected six articles for the review...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27878890/a-qualitative-exploration-of-anesthesia-trainees-experiences-during-transition-to-a-children-s-hospital
#7
Peter W Howe, Koshila Kumar
BACKGROUND: The stresses of starting a new job can make anyone feel tired and inefficient. In health care, this may impair the ability to learn at a time when there is most to learn, and increase the risk of error in a context where errors may lead to patient harm. AIM: The aim of this study was to understand issues which influence anesthesia trainees' transition to a pediatric setting. METHODS: This qualitative study utilized in-depth semi-structured interviews to gather data from 31 anesthesia trainees who had commenced work at a tertiary children's hospital between 4 and 6 weeks previously...
November 22, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#8
Angela K Saettele, Jacob L Christensen, Kelly L Chilson, David J Murray
STUDY OBJECTIVE: Children with congenital or acquired heart disease have an increased risk of anesthesia related morbidity and mortality. The child's anesthetic risk is related to the severity of their underlying cardiac disease, associated comorbidities, and surgical procedure. The goal of this project was to determine the ease of use of a preoperative risk stratification tool for assigning pediatric cardiac staff and to determine the relative frequency that children with low, moderate, and high risk cardiac disease present for non-cardiac surgery at a tertiary pediatric hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871516/pediatric-patients-on-ketogenic-diet-undergoing-general-anesthesia-a-medical-record-review
#9
Elif Soysal, Heike Gries, Carter Wray
STUDY OBJECTIVE: To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). DESIGN: Retrospective medical record review. SETTING: Postoperative recovery area. PATIENTS: All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870272/the-airway-device-preference-may-affect-the-overlapping-of-the-common-carotid-artery-by-the-internal-jugular-vein
#10
Menekse Ozcelik, Cigdem Guclu, Basak Meco, Derya Oztuna, Ahmet Kucuk, Saban Yalcin, Zekeriyya Alanoglu, Neslihan Alkis
BACKGROUND: Anatomical variation in the internal jugular vein (IJV), as well as its small size, tendency to collapse, and proximity to the common carotid artery (CCA) makes central venous cannulation via the IJV a technically challenging procedure, especially in pediatric patients. AIM: We evaluated the effects of laryngeal mask airway insertion and endotracheal intubation (ETT) on the anatomical relationship between the IJV and the CCA in neutral and 40° head away positions...
December 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27861435/intramuscular-fentanyl-and-ketorolac-associated-with-superior-pain-control-after-pediatric-bilateral-myringotomy-and-tube-placement-surgery-a-retrospective-cohort-study
#11
Paul A Stricker, Wallis T Muhly, Ellen C Jantzen, Yue Li, Abbas F Jawad, Alexander S Long, Marcia Polansky, Scott D Cook-Sather
BACKGROUND: Bilateral myringotomy and pressure equalization tube insertion (BMT) is the most common surgery in children. Multiple anesthetic techniques for BMT have been proposed, but that which reliably promotes ideal recovery remains unclear. We sought to assess associations between anesthetic regimens that included single-agent (fentanyl or ketorolac) or dual-agent (fentanyl and ketorolac) analgesic therapy and the primary outcome of maximal postanesthesia care unit (PACU) pain score...
November 17, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27833495/postoperative-pain-management-of-liver-transplantation-in-cystic-fibrosis-is-it-time-to-start-us-guided-neuraxial-blocks
#12
M Piazza, G Martucci, A Arcadipane
Cystic fibrosis (CF) is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anesthetic techniques improve outcomes by reducing anesthetic drugs and administration of opioids, and hastening extubation, awakening, and restarting respiratory of physiotherapy...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27822783/intraoperative-temperature-regulation-in-children-using-a-liquid-warming-garment
#13
Mariya E Skube, Robert D Acton, Victor S Koscheyev, Gloria R Leon, Daniel A Saltzman
PURPOSE: Children undergoing operative intervention while induced under general anesthesia are at risk for experiencing a significant decrease in core body temperature that can lead to adverse systemic effects. Given that the head contributes an estimated 18% of a child's body surface area, we theorized that a liquid-warming garment applied to the head could control a pediatric patient's core body temperature during surgical procedures. METHODS: Patients undergoing elective, non-cranial, general surgical procedures were enrolled in the study...
November 7, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27801973/scai-ccas-spa-expert-consensus-statement-for-anesthesia-and-sedation-practice-recommendations-for-patients-undergoing-diagnostic-and-therapeutic-procedures-in-the-pediatric-and-congenital-cardiac-catheterization-laboratory
#14
Kirsten C Odegard, Robert Vincent, Rahul Baijal, SuAnne Daves, Robert Gray, Alex Javois, Barry Love, Phil Moore, David Nykanen, Lori Riegger, Scott G Walker, Elizabeth C Wilson
Current practice of sedation and anesthesia for patients undergoing pediatric congenital cardiac catheterization laboratory (PCCCL) procedures is known to vary among institutions, a multi-society expert panel with representatives from the Congenital Heart Disease Council of the Society for Cardiovascular Angiography and Interventions (SCAI), the Society for Pediatric Anesthesia (SPA) and the Congenital Cardiac Anesthesia Society (CCAS) was convened to evaluate the types of sedation and personnel necessary for procedures performed in the PCCCL...
November 1, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27785761/using-physiological-monitoring-data-for-performance-feedback-an-initiative-using-thermoregulation-metrics
#15
Matthias Görges, Nicholas C West, Simon D Whyte
BACKGROUND: Feedback of performance data can improve professional practice and outcomes. Vital signs are not routinely used for quality improvement because of their limited access. Intraoperative hypothermia has been associated with deleterious effects, including surgical site infections and bleeding. We speculated that providing feedback could help keep temperature monitoring and management a priority in the anesthesiologist's mind, thereby improving perioperative temperature management...
October 26, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27783767/moderate-sedation-helps-improve-future-behavior-in-pediatric-dental-patients-a-prospective-study
#16
Denise Espíndola Antunes, Karolline Alves Viana, Paulo Sucasas Costa, Luciane Rezende Costa
There is little evidence on the long-term effects of pharmacological management in children undergoing dental treatment. This study aimed to assess children's behavior in consecutive dental sessions following oral rehabilitation using different pharmacological regimens for behavioral control. Participants were preschoolers who were previously treated for caries under one of the following: no sedative, oral sedation with midazolam, oral sedation with midazolam/ketamine, or general anesthesia. The children's behavior in the follow-up sessions was assessed using the Ohio State University Behavioral Rating Scale (OSUBRS); higher scores represented less cooperative behavior (range 5-20)...
October 24, 2016: Brazilian Oral Research
https://www.readbyqxmd.com/read/27752382/airway-management-in-a-patient-with-wolf-hirschhorn-syndrome
#17
John F Gamble, Dinesh J Kurian, Andrea G Udani, Nathaniel H Greene
We present a case of a 3-month-old female with Wolf-Hirschhorn syndrome (WHS) undergoing general anesthesia for laparoscopic gastrostomy tube placement with a focus on airway management. WHS is a rare 4p microdeletion syndrome resulting in multiple congenital abnormalities, including craniofacial deformities. Microcephaly, micrognathia, and glossoptosis are common features in WHS patients and risk factors for a pediatric airway that is potentially difficult to intubate. We discuss anesthesia strategies for airway preparation and management in a WHS patient requiring general anesthesia with endotracheal intubation...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27749349/scai-ccas-spa-expert-consensus-statement-for-anesthesia-and-sedation-practice-recommendations-for-patients-undergoing-diagnostic-and-therapeutic-procedures-in-the-pediatric-and-congenital-cardiac-catheterization-laboratory
#18
Kirsten C Odegard, Robert Vincent, Rahul G Baijal, Suanne M Daves, Robert G Gray, Alexander J Javois, Barry A Love, Philip Moore, David Nykanen, Lori Q Riegger, Scott G Walker, Elizabeth C Wilson
Current practice of sedation and anesthesia for patients undergoing pediatric and congenital cardiac catheterization laboratory (PCCCL) procedures is known to vary among institutions, a multi-society expert panel with representatives from the Congenital Heart Disease Council of the Society for Cardiovascular Angiography and Interventions, the Society for Pediatric Anesthesia and the Congenital Cardiac Anesthesia Society was convened to evaluate the types of sedation and personnel necessary for procedures performed in the PCCCL...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27669400/hypertrophic-pyloric-stenosis-in-the-maritimes-examining-the-waves-of-change-over-time
#19
Alexander C Ednie, Ofer Amram, Jenna Colleen Creaser, Nadine Schuurman, Suzanne Leclerc, Natalie Yanchar
BACKGROUND: Changing patterns of referral and management of pediatric surgical conditions, including hypertrophic pyloric stenosis (HPS), have recently been described and often relate to comfort with early nonoperative management, anesthesia and corrective surgery. Travelling distance required for treatment at pediatric centres can also be burdensome for families. We assessed referral patterns for HPS in the maritime provinces of Canada over 10 years to quantify the burden on families travelling for surgical care...
October 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/27659182/drug-interactions-may-be-important-risk-factors-for-methotrexate-neurotoxicity-particularly-in-pediatric-leukemia-patients
#20
Victoria J Forster, Frederik W van Delft, Susan F Baird, Shona Mair, Roderick Skinner, Christina Halsey
PURPOSE: Methotrexate administration is associated with frequent adverse neurological events during treatment for childhood acute lymphoblastic leukemia. Here, we present evidence to support the role of common drug interactions and low vitamin B12 levels in potentiating methotrexate neurotoxicity. METHODS: We review the published evidence and highlight key potential drug interactions as well as present clinical evidence of severe methotrexate neurotoxicity in conjunction with nitrous oxide anesthesia and measurements of vitamin B12 levels among pediatric leukemia patients during therapy...
November 2016: Cancer Chemotherapy and Pharmacology
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