Cardiac catheterization is an integral part of medical management for pediatric patients with congenital heart disease. Owing to age and lack of cooperation in children who need this procedure, general anesthesia is typically required. These patients have increased anesthesia risk secondary to cardiac pathology. Furthermore, multiple catheterization procedures result in exposure to harmful ionizing...
Randomized trials are important for generating high‐quality evidence, but are perceived as difficult to perform in the pediatric population. Thus far there has been poor characterization of the barriers to conducting trials involving children, and the variation in these barriers between countries remains undescribed. The General Anesthesia compared to Spinal anesthesia (GAS) trial, conducted...
Background and Aims
An immersive virtual reality tour of the operating theater could reduce preoperative anxiety. This study was designed to determine whether a preoperative immersive virtual reality tour demonstrates a reduction in emergence delirium through reducing the preoperative anxiety in children undergoing general anesthesia.
Eighty‐six children were randomly allocated into either...
There is a paucity of data regarding risk stratification of pediatric patients presenting for low‐risk skin and soft tissue surgery.
We sought to determine the incidence and independent predictors of postoperative complications and unplanned 30‐day readmission in a cohort of children undergoing low‐risk skin and soft tissue surgery.
The study included pediatric patients...
Intranasal procedural sedation using dexmedetomidine is well described in the literature. The combination of intranasal dexmedetomidine and ketamine is a novel approach for which there are little data on the rate of successful sedation or adverse events.
The aim of this study is to evaluate the rate of successful sedation and adverse events of intranasal procedural sedation...
The volume of cerebrospinal fluid can affect the pharmacokinetics and pharmacodynamics of local anesthetics for spinal anesthesia and other intrathecal medications.
The objective of this study was to estimate the lumbosacral cerebrospinal fluid volume and thoracolumbosacral cerebrospinal fluid volume using magnetic resonance images in pediatric patients from neonates and infants...
Sedation is often required for young children during transthoracic echocardiography. Dexmedetomidine and ketamine are two sedatives that are commonly used in children for procedural sedation, but they have some disadvantages when they are used alone.
The aim of this retrospective study was to analyze the effects and safety of intranasal sedation with a combination of dexmedetomidine...
Anesthesia services are frequently provided outside of the traditional operating room environment for children. It is unclear if adverse events which occur in off‐site anesthetizing locations result in more severe outcomes compared to events in traditional operating rooms.
We used a multi‐institutional registry of pediatric patients to compare outcomes of perioperative adverse events...
Effective pain management involves a cycle of continual pain assessment, good pain control strategies, and assessment of a standard quality improvement measures. A validated questionnaire that focuses on the quality of postoperative pain management in pediatric surgical patients and parental satisfaction on pain treatment is lacking. We, therefore, modified the revised American Pain Society...
Concern over potential neurotoxicity of anesthetics has led to growing interest in prospective clinical trials using potentially less toxic anesthetic regimens, especially for prolonged anesthesia in infants. Preclinical studies suggest that dexmedetomidine may have a reduced neurotoxic profile compared to other conventional anesthetic regimens; however, coadministration with either anesthetic...
Intravenous acetaminophen is commonly administered as an adjunctive to opioids during major surgical procedures, but neither the correct pharmacokinetic size descriptor nor the dose is certain in severely obese adolescents undergoing bariatric surgery.
Adolescents, 14‐20 years of age, with a body mass index (BMI) ≥95th percentile for age and sex or BMI ≥40 kg·m−2, presenting...
The Pediatric National Surgical Quality Improvement Program (P‐NSQIP) samples surgical procedures for benchmarking and quality improvement. While generally comprehensive, P‐NSQIP does not collect intraoperative physiologic data, despite potential impact on outcomes.
The aims of this study were (a) to describe a methodology to augment P‐NSQIP with vital signs data and (b) demonstrate...
Over a 6‐month period, eight neonates weighing less than 3 kg were operated on at Hospital Nacional Guido Valadares, Dili, Timor‐Leste. Each was operated on for an abdominal condition. There is no postoperative neonatal ventilation, neonatal inotropes, fluid warmers, or parenteral nutrition available at Hospital Nacional Guido Valadares. Medical air and nitrous oxide are unavailable. Oxygen from cylinders...
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