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Pediatric, anesthesia

Mohammed Aloddadi, Safar Alshahrani, Ibrahim Alnaami
The management of hydrocephalus represents a neurosurgical challenge. Ventriculoperitoneal (VP) shunts are usually the treatment of choice for hydrocephalus. However, when VP shunt is not an option, ventriculoatrial (VA) shunt becomes a second choice. VA shunts have special complications such as postoperative neck hematomas, shunt nephritis, and migration of the distal segment. There are two main techniques for the retrieval of migrated VA shunt: either by retrieval of the broken segment by thoracotomy, which is highly invasive, or by transvenous approach...
January 2018: Journal of Pediatric Neurosciences
Tatsuya Osuga, Yoshihiro Ikura, Kazunori Hasegawa, Seiichi Hirano
Endoscopic balloon dilation (EBD) is an established therapy for esophageal stenosis. To assess its usefulness in children, we reviewed 11 years of pediatric cases of EBD in our hospital. Over the last 11 years, EBD was performed on 14 pediatric patients (10 boys and four girls; 7 months-11 years) at our hospital. All EBD sessions were performed under general anesthesia and fluoroscopic monitoring. The sessions were repeated every week or alternate weeks until resolution of dysphagia or development of smooth endoscope passage...
January 2018: Esophagus: Official Journal of the Japan Esophageal Society
Derek Yecies, Nathaniel Fogel, Michael Edwards, Gerald Grant, Kristen W Yeom, Samuel Cheshier
OBJECT: The need for neurosurgical supervision as well as the general safety and utility of dynamic MRI of the cervical spine in children remains controversial. We present the largest descriptive cohort study of cervical flexion-extension MRIs in a pediatric population to help elucidate the safety and utility of this technique. METHODS: All cervical spine MRIs performed at Lucile Packard Children's Hospital at Stanford from 2009-2015 were retrospectively reviewed...
June 5, 2018: World Neurosurgery
Lauren Oswald, Emma-Jane Smith, Malcolm Mathew, Chulananda Goonasekera
Ayre's T-piece, first introduced 80 years ago, continues to be widely used in pediatric anesthesia despite colossal advances in equipment and technology. We present a review of its history, advantages, and disadvantages, and place in modern-day clinical practice.
June 7, 2018: Paediatric Anaesthesia
Niekla Survia Andiesta, Maimunah A Hamid, Kkc Lee, Allan Pau
BACKGROUND: In 2012, nearly 4000 children in Malaysia were referred to hospital pediatric dental services due to dental caries. Recent research has reported the effectiveness of dental home visits in preventing caries development in young children. Dental home visits (DHVs) are described as an ongoing relationship between the dentist and their patients, providing all aspects of a preventive oral health care program in the presence of the parents at home. OBJECTIVE: The objective of this study is to evaluate the cost-effectiveness of dental home visits and oral health information, in the form of educational leaflets, in preventing new caries development in young children, compared to those receiving only educational leaflets over a period of two years...
June 6, 2018: JMIR Research Protocols
Suhas Ganguli, Qing Liu, Apostolis Tsoumpariotis, Susana Rapaport, Esra Fakioglu
Vaginal discharge in prepubescent girls is not an uncommon problem in pediatric outpatient practice. Among its various etiologies, foreign body lodgement is quite frequent in this age group. Diagnosis is sometimes forthcoming after history and physical exam, and the removal of the foreign object is followed by a prompt resolution of symptoms. However, in rare circumstances, an intravaginal foreign body may mimic other pathologies, including infections and neoplasms, as well as raising suspicion for child abuse...
April 4, 2018: Curēus
Marilyn Butler, Elizabeth Drum, Faye M Evans, Tamara Fitzgerald, Jason Fraser, Ai-Xuan Holterman, Howard Jen, Matthew Kynes, Jenny Kreiss, Craig D McClain, Mark Newton, Benedict Nwomeh, James O'Neill, Doruk Ozgediz, George Politis, Henry Rice, David Rothstein, Julie Sanchez, Mark Singleton, Francine S Yudkowitz
Pediatric surgeons, anesthesia providers, and nurses from North America and other high-income countries are increasingly engaged in resource-limited areas, with short-term missions as the most common form of involvement. However, consensus recommendations currently do not exist for short-term missions in pediatric general surgery and associated perioperative care. The American Academy of Pediatrics (AAP) Delivery of Surgical Care Subcommittee and American Pediatric Surgical Association (APSA) Global Pediatric Surgery Committee, with the American Pediatric Surgical Nurses Association, Inc...
May 2018: Paediatric Anaesthesia
A Böer-Auer, R Fölster-Holst
Compared with adulthood, inflammatory skin diseases are relatively rarely biopsied in children. Apart from the invasiveness of the procedure, the required local anesthesia, and the risks of infection and scarring, the psychological trauma of the operation has a higher impact in childhood. If a biopsy is performed, expectations towards the dermatopathology report are high. However, the evaluation of biopsies taken from children is challenging for the dermatopathologist: on the one hand, because the biopsies are often tiny or just superficial shaves and, on the other hand, because criteria for evaluation have mostly been developed from findings in adult biopsy specimens...
June 4, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Sara Ferraz, Telma Caria, Aline Vaz Da Silva, Maria Jose Candeias, Teresa Cenicante
Introduction: Opioids are used intrathecally to manage surgical pain. There are few reports of hypothermia after spinal morphine injection, none in the pediatric population. We present a teenager's case of mild hypothermia. Case Presentation: A 15-year-old boy was scheduled for elective abdominal laparotomy. General anesthesia was combined with spinal anesthesia, using levobupivacaine and morphine. In the recovery room, he presented a decreased tympanic temperature (34...
February 2018: Anesthesiology and Pain Medicine
M A Nardiello, M Herlitz
Numerous publications have emerged on the application of erector spinae plane block in adult population. There are few reports of the use of this block in pediatric patients. The objective is to report 2 cases of adolescents, one diagnosed with pectus excavatum and the other one with pectus carinatum undergoing reconstructive surgery in which a bilateral single-shot erector spinae plane block was performed as an analgesic technique. The block was performed before surgery under general anesthesia in lateral decubitus position, guided by ultrasound using 20ml of 0...
June 1, 2018: Revista Española de Anestesiología y Reanimación
Patrick Scheiermann, Friederike Herzog, Andrea Siebenhofer, Reinhard Strametz, Tobias Weberschock
STUDY OBJECTIVE: General anesthesia is commonly used in pediatric inpatient surgery. It can be induced and maintained by either intravenous or volatile anesthetic agents. We aimed to elucidate whether intravenous or volatile anesthetic agents are superior with regards to preventing anesthesia-related complications. DESIGN: Using a predefined standardized study protocol we conducted a systematic review of randomized controlled trials (RCTs) with meta-analysis where appropriate searching the following data bases: CENTRAL, MEDLINE, EMBASE, metaRegister of Controlled Trials (until June 2016)...
May 31, 2018: Journal of Clinical Anesthesia
James W Ochi, Andrew C Richardson
OBJECTIVE: Medical acupuncture is increasingly recognized for reducing postoperative pain, nausea and emergence agitation. Anesthetic induction is an ideal time to perform acupuncture in an effort to reduce the adverse side effects of surgery. Acupuncture is safe, inexpensive and does not lengthen the duration of anesthesia. There are however no published reports of how often patients will choose intraoperative acupuncture when given the opportunity to do so. METHODS: A retrospective review of all surgical procedures performed by one surgeon over 12 months was done...
July 2018: International Journal of Pediatric Otorhinolaryngology
Kenneth A Michelson, Todd W Lyons, Joel D Hudgins, Jason A Levy, Michael C Monuteaux, Jonathan A Finkelstein, Richard G Bachur
OBJECTIVES: Differences in emergency care for children exist between general and pediatric emergency departments (EDs). Some pediatric quality measures are available but are not routinely employed nationwide. We sought to create a short list of applied measures that would provide a starting point for EDs to measure pediatric emergency care quality, and to compare care between general and pediatric EDs for these measures. METHODS: Previously reported lists comprising 465 pediatric emergency care quality measures were reconciled...
June 2, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Dean M DeLuke, Darriel Cannon, Caroline Carrico, B Ellen Byrne, Daniel M Laskin
Administration of safe and effective local anesthesia is a cornerstone of dental practice, but there is some discrepancy in recommendations for maximum doses, with the Council on Dental Therapeutics and American Academy of Pediatric Dentistry's guidelines differing from the guidelines of manufacturers and contemporary textbooks. The aim of this study was to determine the level of uniformity across U.S. dental schools in teaching maximal safe doses for commonly used local anesthetics. Faculty members primarily responsible for teaching local anesthesia to dental students at all 62 U...
June 2018: Journal of Dental Education
Farshid Alizadeh, Seyed Morteza Heydari, Reza Nejadgashti
BACKGROUND: Intraoperative blood loss is considered to be an important issue in hypospadias surgery. Some studies have demonstrated the utility of caudal epidural block (CEB) in this regard among pediatric patients with hypospadias. Though there is evidence in favor of the use of CEB as the only anesthetic method for pediatric surgeries, it is usually used in combination with general anesthesia. In this form of use, it could have more favorable outcomes for both intra- and postoperative periods...
May 21, 2018: Journal of Pediatric Urology
Ramón Eizaga Rebollar, María Victoria García Palacios, Javier Morales Guerrero, Luis Miguel Torres Morera
Spinal anesthesia is practical and safe in infants and toddlers and prevents perioperative complications including cardiorespiratory instability and apnea. Other perioperative advantages include reduced time from surgery completion to operating room exit and first feed. This article presents the case of an ex-premature infant who underwent laparoscopic inguinal hernia repair under spinal anesthesia. The infant remained calm and stable throughout the uneventful procedure and postoperative period. Spinal anesthesia may be feasible for laparoscopic herniotomy when pneumoperitoneum pressure and operative time are restricted to 8 mm Hg and 60 minutes, respectively, with sensory level at T10 or higher...
May 29, 2018: A&A practice
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
May 30, 2018: Paediatric Anaesthesia
Ji-Soo Song, Hong-Keun Hyun, Teo Jeon Shin, Young-Jae Kim
BACKGROUND: The findings that not only dental caries but also systemic disease can exert a negative effect on oral health-related quality of life (OHRQoL), and that dental treatment can improve OHRQoL have been confirmed in multiple studies. The purpose of this study is to investigate the impact of dental treatment on OHRQoL of Korean pediatric patients and the differences in OHRQoL between patients with and without systemic disease. METHODS: All the primary caregivers of pediatric patients who underwent dental treatments under either general anesthesia or intravenous deep sedation at Seoul National University Dental Hospital completed abbreviated versions of the Child Oral Health Impact Profile (COHIP-14) and Family Impact Scale (FIS-12) surveys on OHRQOL pre- and post-treatment (average: 2...
May 29, 2018: BMC Oral Health
Marisa A Bartz-Kurycki, Kathryn T Anderson, Dylan N Supak, Stephanie N Wythe, Grant M Garwood, Robert F Martin, Rigoberto Gutierrez, Ranu R Jain, Akemi L Kawaguchi, Lillian S Kao, KuoJen Tsao
BACKGROUND: The World Health Organization recommends including the parents in completion of the pediatric surgical safety checklist. At our hospital, the preinduction surgical safety checklist is conducted in the preoperative holding with anesthesia, nursing, and often with the parents of children undergoing an operative procedure. We hypothesized that adherence to the preinduction checklist is better when parents are engaged in surgical safety checklist performance. METHODS: An observational study of adherence to the preinduction checklist for nonemergent pediatric operations was performed (2016-2017)...
May 23, 2018: Surgery
Ira L Leeds, Mitchell R Ladd, Margaret H Sundel, Melissa L Fannon, Jessica A George, Emily F Boss, Eric B Jelin
BACKGROUND/PURPOSE: The role of process measures used to predict quality in pediatric colorectal surgery enhanced recovery protocols has not been described. The purpose of this study was to demonstrate the feasibility of abstracting and monitoring process measures over protocol improvement iteration. METHODS: Patients enrolled in the Pediatric Colorectal Enhanced Recovery After Surgery pathway at our institution were grouped by stage of implementation. We used a quality improvement database to compare multistage enhanced recovery process measures and 30-day patient outcomes...
May 4, 2018: Journal of Pediatric Surgery
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