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Pediatric anesthesia case report

Christopher F Tirotta, Tuan Nguyen, Steven Fishberger, Evelio Velis, Melissa Olen, Lourdes Lam, Danielle R Madril, Jessica Hughes, Richard G Lagueruela
BACKGROUND: Dexmedetomidine is a selective alpha-2 adrenergic agonist with sedative, analgesic, and anxiolytic properties. Dexmedetomidine has not been approved for use in pediatrics. Dexmedetomidine has been reported to depress sinus node and atrioventricular nodal function in pediatric patients; it has been suggested that the use of dexmedetomidine may not be desirable during electrophysiological studies. AIM: We hypothesize that the use of dexmedetomidine does not inhibit the induction of supraventricular tachyarrhythmias (SVT) during electrophysiological studies and does not inhibit the ablation of such arrhythmias...
October 25, 2016: Paediatric Anaesthesia
Ahmad S Azhar
OBJECTIVES: To assess the safety and effectiveness of transthoracic echocardiography (TTE) in monitoring transcatheter closure of atrial septal defect (ASD), in comparison with conventional technique using transesophageal echocardiography (TEE).  Methods: A retrospective review of all cases of transcatheter closure of isolated ostium secundum ASDs operated from 2005 to 2015, at the Pediatric Interventional Cardiology Department, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia...
November 2016: Saudi Medical Journal
Takaki Emura, Kenji Hosoda, Shota Harai, Noboru Oyachi, Takeyuki Suzuki, Ken Takada, Koji Kobayashi, Hisatake Ikeda
BACKGROUND: Massive gastrointestinal bleeding in children, mostly caused by esophageal varices secondary to chronic liver disease, is uncommon. Dieulafoy lesion in the gastrointestinal tract is a rare but important cause of gastrointestinal bleeding; massive bleeding from this lesion can be fatal unless adequate treatment is promptly initiated. We report a case of gastric Dieulafoy lesion in a 2-year old successfully treated with endoscopic hemoclipping. CASE PRESENTATION: A 2-year-old Japanese boy was admitted to our department with sudden massive hematemesis...
October 19, 2016: Journal of Medical Case Reports
Marie-Cécile Valéra, Isabelle Aragon, Paul Monsarrat, Fréderic Vaysse, Emmanuelle Noirrit-Esclassan
OBJECTIVE: The aim of this study was to evaluate the attitude of parents towards the oral health of their children before oral rehabilitation under general anesthesia (GA). STUDY DESIGN: Children receiving dental treatment under GA between November 2013 and July 2014 in the Pediatric Dentistry Department (University Hospital Center, Toulouse, France) were enrolled in an oral health preventive program. An anonymous questionnaire was self-administered by the parents during the pre-operative session...
2016: Journal of Clinical Pediatric Dentistry
Vikul Kumar, Atul Kumar Singh, Kulwant Singh Bhaikhel
Blowout fractures are a common occurrence in traumatic brain injury patients. In pediatric age group, orbital floor fracture is a common occurrence. We report a case of 2-year-old male admitted to trauma center, with penetrating injury to the left eye by the clutch of motorbike which fell on the child. Noncontrast computed tomography scan revealed fracture of the roof of left orbit with left frontal contusion sparing the left eyeball. There was also the continuous leak of brain matter from the left eye which suggested tear of dura mater...
April 2016: Journal of Pediatric Neurosciences
Eric Hohn, Nirav K Pandya
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is one of several surgical procedures used to treat patellofemoral instability. Use of allograft tissue can preserve autogenous tissue and may be preferable in patients with connective tissue disorders or ligamentous laxity. Although there are successful reports in adults, it is unclear if the use of allograft tissue in MPFL reconstruction can restore patellofemoral stability in children and adolescents. QUESTIONS/PURPOSES: (1) Does allograft tissue in MPFL reconstruction in pediatric and adolescent patients restore patellar stability? (2) What complications were associated with allograft MPFL reconstructions in children and adolescents? METHODS: Between June 2012 and August 2015, one surgeon (NKP) performed 26 MPFL reconstructions in 23 patients with gracilis allograft for traumatic patellar instability...
September 2, 2016: Clinical Orthopaedics and related Research
Mustafa Azizoglu, Handan Birbicer, Suleyman Memis, Hakan Taşkınlar
Sugammadex is a selective chemical agent that can reverse neuromuscular blockade induced by vecuronium and rocuronium. The aim of this report is to discuss the effectiveness of sugammadex in the reversal of neuromuscular blockade in children younger than 2 years. A 16-month-old boy, weighing 10 kg, was admitted to the pediatric emergency department due to choking, cyanosis, and severe respiratory distress that occurred while he was eating peanuts. In the emergency department, the patient's condition deteriorated, and he went into respiratory arrest...
September 2016: Journal of Clinical Anesthesia
Elizabeth K Landry, Rodney A Gabriel, Sascha Beutler, Richard P Dutton, Richard D Urman
BACKGROUND: Currently, there are only a few retrospective, single-institution studies that have addressed the prevalence and risk factors associated with unplanned admissions to the pediatric intensive care unit (ICU) after surgery. Based on the limited amount of studies, it appears that airway and respiratory complications put a child at increased risk for unplanned ICU admission. A more extensive and diverse analysis of unplanned postoperative admissions to the ICU is needed to address risk factors that have yet to be revealed by the current literature...
August 15, 2016: Journal of Intensive Care Medicine
Carmen Sulton, Courtney McCracken, Harold K Simon, Kiran Hebbar, Jason Reynolds, Joseph Cravero, Michael Mallory, Pradip Kamat
OBJECTIVES: Dexmedetomidine (DEX) is widely used in pediatric procedural sedation (PPS) by a variety of pediatric subspecialists. The objective of our study was to describe the overall rates of adverse events and serious adverse events (SAEs) when DEX is used by various pediatric subspecialists. METHODS: Patients from the Pediatric Sedation Research Consortium (PSRC) database were retrospectively reviewed and children that received DEX as their primary sedation agent for elective PPS were identified...
September 2016: Hospital Pediatrics
Goran Rakić, Danica Stanić, Anna Uram Benka, Marina Pandurov, Jovana M Simin, Biljana Drasković
INTRODUCTION: Children who are subjected to surgical treatment for scoliosis usually end up receiving a lot of blood transfusions since they tend to lose one or more blood volumes during the surgery. Tranexamic acid is an antifibrinolytic agent, increasingly used in children to reduce perioperative blood loss in various settings, including corrective surgery of scoliosis. CASE REPORT: A 12-year-old girl, weighing 44 kg, was admitted to our hospital for scoliosis correction...
March 2016: Medicinski Pregled
Ciro Esposito, Maria Escolino, Giuseppe Cortese, Gianfranco Aprea, Francesco Turrà, Alessandra Farina, Agnese Roberti, Mariapina Cerulo, Alessandro Settimi
BACKGROUND: The role of laparoscopy in pediatric inguinal hernia (IH) is still controversial. The authors reported their twenty-year experience in laparoscopic IH repair in children. METHODS: In a twenty-year period (1995-2015), we operated 1300 infants and children (935 boys-365 girls) with IH using laparoscopy. The average age at surgery was 18 months (range 7 days-14 years). Body weight ranged between 1.9 and 50 kg (average 9.3). Preoperatively all patients presented a monolateral IH, right-sided in 781 cases (60...
August 5, 2016: Surgical Endoscopy
Neeraj Solanki, Anuj Kumar, Neha Awasthi, Anjali Kundu, Suveet Mathur, Suresh Bidhumadhav
INTRODUCTION: Dental problems serve as additional burden on the children with special health care needs (CSHCN) because of additional hospitalization pressure, they face for the treatment of various serious medical problems. These patients have higher incidence of dental caries due to increased quantity of sugar involved in the drug therapies and lower salivary flow in the oral cavity. Such patients are difficult to treat with local anesthesia or inhaled sedatives. Single-sitting dental treatment is possible in these patients with general anesthesia...
2016: Journal of Contemporary Dental Practice
Taner Ciftci, Serkan Erbatur
We report the case ofa pediatric patient with tetralogy of Fallot (TOF) and cleft palate deformity with difficult intubation in which a laryngeal mask airway (LMA) was used and converted into an endotracheal tube through retrograde intubation. The patient with TOF was scheduled for repair of the congenital bilateral cleft lip and palate. Inhalational induction with 4% sevoflurane was started. Conventional tracheal intubation was impossible because the patient had a difficult airway, and the procedure could cause severe cyanosis and respiratory distress...
February 2016: Middle East Journal of Anesthesiology
Jianrong Guo, Xiaoju Jin, Huan Wang, Jun Yu, Xiaofang Zhou, Yong Cheng, Qiang Tao, Li Liu, Jianping Zhang
Desflurane, halothane, isoflurane, propofol, and sevoflurane are widely used anesthetics in pediatric anesthesia. Adverse effect including emergence agitation, postoperative nausea and vomiting, and postoperative pain are common. Prolonged extubation time and emergency time are also troubling anesthesiologists. Previous studies have noted the characteristics of various anesthetics in pediatric anesthesia, while the results were inconclusive and conflicting. In this study, we aimed at performing a comprehensive network meta-analysis concerning the emergence and recovery characteristics of pediatric anesthetics...
June 24, 2016: Molecular Neurobiology
Ramón Eizaga Rebollar, María V García Palacios, Javier Morales Guerrero, Luis M Torres Morera
We report the case of a 17-month-old child who underwent laparotomy under general anesthesia and caudal block. Electrocardiogram ST-T changes were observed after local anesthetic injection. The prompt use of Intralipid 30% was successful in normalizing ECG alterations. Our experience is consistent with previous literature, mainly carried out in adults. Thereby, we conduct a brief review of the subject in pediatrics. As a major conclusion, we strongly recommend the "fast-track" lipid rescue as soon as this severe complication is detected...
August 2016: Journal of Clinical Anesthesia
Kanani E Titchen, Douglas Katz, Kidian Martinez, Krishna White
The topic of child sex trafficking is receiving increased attention both in the lay press and in research articles. Recently, a number of physician organizations have issued policy statements calling for the education and involvement of physicians in combating this form of "modern-day slavery." Primary care and emergency medicine physicians have led these efforts, but a number of these victims may present to surgeons. Surgeons are in a unique position to identify trafficked patients; during the process of undraping, intubation, and surgical preparation, signs of trafficking such as tattoos, scars, dental injuries, and bruising may be evident...
May 2016: Pediatrics
Yoshihiro Yonekawa, Wei-Chi Wu, Shunji Kusaka, Joshua Robinson, Daishi Tsujioka, Kai B Kang, Michael J Shapiro, Tapas R Padhi, Lubhani Jain, Jonathan E Sears, Ajay E Kuriyan, Audina M Berrocal, Polly A Quiram, Amanda E Gerber, R V Paul Chan, Karyn E Jonas, Sui Chien Wong, C K Patel, Ashkan M Abbey, Rand Spencer, Michael P Blair, Emmanuel Y Chang, Thanos D Papakostas, Demetrios G Vavvas, Robert A Sisk, Philip J Ferrone, Robert H Henderson, Karl R Olsen, M Elizabeth Hartnett, Felix Y Chau, Shizuo Mukai, Timothy G Murray, Benjamin J Thomas, P Anthony Meza, Kimberly A Drenser, Michael T Trese, Antonio Capone
PURPOSE: To determine the feasibility and safety of bilateral simultaneous vitreoretinal surgery in pediatric patients. DESIGN: International, multicenter, interventional, retrospective case series. PARTICIPANTS: Patients 17 years of age or younger from 24 centers worldwide who underwent immediate sequential bilateral vitreoretinal surgery (ISBVS)-defined as vitrectomy, scleral buckle, or lensectomy using the vitreous cutter-performed in both eyes sequentially during the same anesthesia session...
August 2016: Ophthalmology
Takeshi Ueno, Nobuyasu Komasawa, Sayuri Matsunami, Nozomi Majima, Yusuke Kusaka, Toshiaki Minami
We report the anesthetic management of a pediatric case of blue rubber bleb nevi syndrome combined with small-intestinal intussusception. A 2-year-old girl was transferred to our hospital for small-intestinal intussusception. Emergent ablation of the upper gastrointestinal tract nevus under general anesthesia was planned. Given the presence of several nevi in the oral and pharyngeal space, we utilized the McGRATH MAC (McGRATH; Aircraft Medical Ltd, United Kingdom) laryngoscope for gentle and stress-free tracheal intubation...
April 2016: Masui. the Japanese Journal of Anesthesiology
Sayo Iwasai, Yoko Kinoshita, Yutaro Asagoe, Takashi Matsuzaki, Minako Arai, Tetsufumi Sato
Anaphylactoid reaction is a rapid systemic allergic reaction to many kinds of allergen. The peak age of onset is in the forties and there are not many reports on anaphylactoid reactions in pediatric patients. We report two cases of pediatric patients who underwent surgical treatment on retinoblastoma and developed anaphylactoid reaction probably caused by neostigmine. General anesthesia was induced with fentanyl, sevoflurane, dinitrogen monoxide, and rocronium. The procedure was uneventfully completed. Just after the administration of neostigmine to reverse rocronium, the patients showed red flare on the face and chest, and wheezes were heard, but the vital signs were relatively stable...
April 2016: Masui. the Japanese Journal of Anesthesiology
Rodney A Gabriel, Albert Wu, Chuan-Chin Huang, Richard P Dutton, Richard D Urman
STUDY OBJECTIVE: The operating room suite can be one of the most costly units within the hospital. Some of these costs stem from postoperative unplanned admissions, case cancellations, case delays, and extended recovery room times. The objective is to determine the clinical predictors of these operating room inefficiencies. DESIGN: Retrospective data analysis. SETTING: Operating room, postoperative recovery area. PATIENTS: Surgical patients whose perioperative data were reported to the Anesthesia Quality Institute's National Anesthesia Clinical Outcomes Registry from 2010 to 2015...
June 2016: Journal of Clinical Anesthesia
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