MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Pediatric Anesthesia' source. Wed, 08 Feb 2012 07:39:23 +0100 http://www.medworm.com/index.php?rid=5666598&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03810.x Conclusion:  These findings demonstrate that a single administration of DEX to rats on P7 preserves hippocampal synaptic plasticity as well as synaptic transmission later in life. In view of the some evidence that have demonstrated the permanent detrimental impact of commonly used anesthetics on neurological outcomes after neonatal exposure, our findings may suggest the relative safety of DEX administered as a sedative agent to neonatal animals with regard to the development of hippocampal synaptic functions. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5666598 Wed, 08 Feb 2012 12:08:52 +0100 5666598 http://www.medworm.com/index.php?rid=5666601&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03803.x Conclusion:  We recommend an optimal time of 3.5 min for attempting intravenous cannulation after the loss of eyelash reflex with sevoflurane induction. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5666601 Mon, 06 Feb 2012 05:00:00 +0100 5666601 http://www.medworm.com/index.php?rid=5666600&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03805.x We present a review of smartphone applications (apps) available for pediatric anesthesia. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5666600 Mon, 06 Feb 2012 05:00:00 +0100 5666600 http://www.medworm.com/index.php?rid=5666599&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03809.x Conclusion:  Ropivacaine (0.2% 0.4 ml·kg−1) for ABPB provides sufficient postoperative analgesia in children scheduled for forearm or hand surgery. The addition of clonidine to ABPB does not improve overall postoperative analgesia but may increase the time to first analgesia request. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5666599 Mon, 06 Feb 2012 05:00:00 +0100 5666599 http://www.medworm.com/index.php?rid=5646856&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03801.x Conclusions:  We conclude that the size 1 PLMA is a stable, safe, and efficacious airway control device during neonatal and infant anesthesia, allowing higher peak airway pressure during positive pressure ventilation, with fewer mask displacements and gastric insufflations than the cLMA. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5646856 Thu, 02 Feb 2012 12:09:21 +0100 5646856 http://www.medworm.com/index.php?rid=5627942&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03797.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627942 Thu, 26 Jan 2012 12:13:28 +0100 5627942 http://www.medworm.com/index.php?rid=5627941&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03790.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627941 Thu, 26 Jan 2012 12:13:26 +0100 5627941 http://www.medworm.com/index.php?rid=5627940&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03748.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627940 Thu, 26 Jan 2012 12:13:24 +0100 5627940 http://www.medworm.com/index.php?rid=5627939&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03765.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627939 Thu, 26 Jan 2012 12:13:22 +0100 5627939 http://www.medworm.com/index.php?rid=5627938&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03768.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627938 Thu, 26 Jan 2012 12:13:20 +0100 5627938 http://www.medworm.com/index.php?rid=5627937&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03786.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627937 Thu, 26 Jan 2012 12:13:18 +0100 5627937 http://www.medworm.com/index.php?rid=5627936&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03785.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627936 Thu, 26 Jan 2012 12:13:16 +0100 5627936 http://www.medworm.com/index.php?rid=5627935&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03794.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627935 Thu, 26 Jan 2012 12:13:14 +0100 5627935 http://www.medworm.com/index.php?rid=5627934&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03784.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627934 Thu, 26 Jan 2012 12:13:12 +0100 5627934 http://www.medworm.com/index.php?rid=5627933&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03764.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627933 Thu, 26 Jan 2012 12:13:10 +0100 5627933 http://www.medworm.com/index.php?rid=5627932&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03740.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627932 Thu, 26 Jan 2012 12:13:08 +0100 5627932 http://www.medworm.com/index.php?rid=5627931&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03775.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627931 Thu, 26 Jan 2012 12:13:06 +0100 5627931 http://www.medworm.com/index.php?rid=5627930&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03779.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627930 Thu, 26 Jan 2012 12:13:04 +0100 5627930 http://www.medworm.com/index.php?rid=5627928&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03800.x Conclusions:  Anesthesiologists in the Netherlands take a different approach when caring for intellectually disabled children and they were not aware of pain observation scales for these children. However, the majority think that intellectually disabled children are not more sensitive to pain or require more analgesia. These opinions did not change over the 4‐year period. One way to proceed is to implement validated pain assessment tools and to invest in education. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627928 Thu, 26 Jan 2012 12:11:28 +0100 5627928 http://www.medworm.com/index.php?rid=5619601&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03796.x Conclusions:  Clinically significant intraoperative hyponatremia was not a feature of major craniofacial surgery in our institution. Mild postoperative hyponatremia was relatively common on POD1. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5619601 Mon, 23 Jan 2012 12:11:49 +0100 5619601 http://www.medworm.com/index.php?rid=5627929&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03802.x Conclusion:  Intranasal dexmedetomidine and midazolam are equally effective in decreasing anxiety upon separation from parents; however, midazolam is superior in providing satisfactory conditions during mask induction. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5627929 Mon, 23 Jan 2012 05:00:00 +0100 5627929 http://www.medworm.com/index.php?rid=5619602&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03789.x We report a challenging case of a 10‐year‐old boy with history of biventricular heart failure, pulmonary hypertension, severe asthma, and obesity with a BMI of 37. He presented to our hospital in acute decompensated heart failure. Our anesthesia team was consulted by the pediatric intensivist for urgent airway management in this rapidly deteriorating, premorbid patient. We describe here the use of the GlideScope® in an awake pediatric patient of ASA 4E status with a potentially difficult airway who required to remain in the seated position and thus necessitating a face‐to‐face approach. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5619602 Mon, 23 Jan 2012 05:00:00 +0100 5619602 http://www.medworm.com/index.php?rid=5607852&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03798.x Conclusions:  Impairment of clot formation by moderate isovolaemic hemodilution did not significantly differ between ICS, GEL, and HES. Profound hemodilution of more than 50% of the estimated blood volume with GEL and HES caused significant impairment of clot formation in comparison to ICS and has to be considered when using high amounts of these synthetic colloids. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5607852 Fri, 20 Jan 2012 12:11:25 +0100 5607852 http://www.medworm.com/index.php?rid=5607853&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03795.x This article aims to provide a comprehensive review of airway management in such patients, focusing on challenges encountered during mask ventilation and tracheal intubation, as well as the role of surgical release of neck contractures to facilitate tracheal intubation. Lessons learned from all reported cases identified in a thorough literature search are incorporated into this review. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5607853 Thu, 19 Jan 2012 05:00:00 +0100 5607853 http://www.medworm.com/index.php?rid=5596840&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2012.03799.x The physiological application of OHMS LAW explains the basis of hypotensive anesthesia.V = IR translates into:Pressure = Flow × Resistance orBlood pressure = Cardiac Output × Peripheral Resistance.If peripheral resistance is reduced by a vasodilator such as sodium nitroprusside (a short acting, vascular smooth muscle relaxant) or phenoxybenzamine (a long acting α adrenoreceptor antagonist), blood pressure will fall and vasoconstriction and bleeding will be reduced. A less desirable alternative to lowering blood pressure could be to reduce cardiac output by suppressing myocardial contractility using a ß1 adrenoceptor antagonist or an inhalational agent such as isoflurane. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5596840 Tue, 17 Jan 2012 12:09:51 +0100 5596840 http://www.medworm.com/index.php?rid=5580789&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03791.x SummaryA six week old infant underwent ventricular septal defect and atrial septal defect closure. Preoperative echocardiography showed evidence of pulmonary hypertension. The post operative course was complicated failure to wean from ventilatory and inotropic support. Echocardiography showed severe left ventricular (LV) dysfunction and suggested some fistulous drainage of the left coronary artery into the right pulmonary artery; this anomalous drainage of the left coronary artery into the right pulmonary artery (ALCAPA) was confirmed with coronary angiogram. Re‐implantation of the left coronary artery into the aorta was performed. Extra‐corporeal membrane oxygenation (ECMO) was required to allow time for ventricular recovery. Supports were weaned gradually, with concurrent evidence of... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5580789 Fri, 13 Jan 2012 12:08:52 +0100 5580789 http://www.medworm.com/index.php?rid=5580790&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03788.x SummaryThe pharmacokinetic (PK) parameters that are important for dosing (e.g., clearance and volume) are well known. They are used in universal mathematical formulae that describe the time course of drug concentration. Additional formulae can be used to describe major covariate effects in children, such as size and maturation. PK parameters describing the time–concentration profile of a drug after administration are those for a typical individual in a population. These parameters are associated with variability. Further, any one individual may not be typical of the population studied. While size and maturation are two important considerations in children and assist with dosing estimation, there are also a number of additional PK covariates (e.g., organ function, disease, drug interactio... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5580790 Mon, 09 Jan 2012 05:00:00 +0100 5580790 http://www.medworm.com/index.php?rid=5571829&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03787.x Conclusion:  The majority of respondents to this survey reported that they would usually establish IV access in children undergoing general anesthesia except in specific circumstances. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5571829 Sun, 08 Jan 2012 12:09:42 +0100 5571829 http://www.medworm.com/index.php?rid=5559312&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03741.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559312 Wed, 04 Jan 2012 16:37:16 +0100 5559312 http://www.medworm.com/index.php?rid=5559311&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03734.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559311 Wed, 04 Jan 2012 16:37:14 +0100 5559311 http://www.medworm.com/index.php?rid=5559310&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03733.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559310 Wed, 04 Jan 2012 16:37:13 +0100 5559310 http://www.medworm.com/index.php?rid=5559309&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03746.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559309 Wed, 04 Jan 2012 16:37:11 +0100 5559309 http://www.medworm.com/index.php?rid=5559308&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03723.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559308 Wed, 04 Jan 2012 16:37:09 +0100 5559308 http://www.medworm.com/index.php?rid=5559307&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03761.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559307 Wed, 04 Jan 2012 16:37:08 +0100 5559307 http://www.medworm.com/index.php?rid=5559306&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03721.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559306 Wed, 04 Jan 2012 16:37:06 +0100 5559306 http://www.medworm.com/index.php?rid=5559305&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03698.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559305 Wed, 04 Jan 2012 16:37:04 +0100 5559305 http://www.medworm.com/index.php?rid=5559304&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03699.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559304 Wed, 04 Jan 2012 16:37:02 +0100 5559304 http://www.medworm.com/index.php?rid=5559303&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03673.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559303 Wed, 04 Jan 2012 16:37:01 +0100 5559303 http://www.medworm.com/index.php?rid=5559302&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03694.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559302 Wed, 04 Jan 2012 16:36:59 +0100 5559302 http://www.medworm.com/index.php?rid=5559300&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03667.x SummaryA 15 month old boy with a ventricular septal defect (VSD) underwent percutaneous device closure of the VSD. Five days later he collapsed; on arrival to hospital he was asystolic and received prolonged cardio‐pulmonary resuscitation (CPR) with intermittent return of spontaneous circulation (ROSC). He had recurrent episodic complete heart block with no ventricular escape rhythm, associated with loss of cardiac output, unresponsive to transcutaneous pacing. He was transferred to theatre, while receiving CPR, for urgent removal of the VSD device. Estimated total ‘down time’ was 70 min. The device was removed and patch closure of the VSD was performed. He made a full neurological recovery. Device closure of septal defects has become widespread. We discuss the incidence and type of ... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559300 Wed, 04 Jan 2012 16:36:55 +0100 5559300 http://www.medworm.com/index.php?rid=5559298&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03752.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5559298 Wed, 04 Jan 2012 16:36:38 +0100 5559298 http://www.medworm.com/index.php?rid=5551862&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03771.x Conclusions:  Epidural infusions of 0.2 mg−1·kg−1·h−1 bupivacaine or ropivacaine appeared to be well tolerated and efficacious in this population. No accumulation of unbound drug concentrations occurred. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5551862 Sat, 31 Dec 2011 00:42:14 +0100 5551862 http://www.medworm.com/index.php?rid=5551867&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03769.x Conclusions:  These preliminary findings show that hemodynamic parameters in infants with CHD undergoing NCS under awake SA are not different from controls without CHD and that SA appears to be safe in infants with CHD. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5551867 Wed, 28 Dec 2011 05:00:00 +0100 5551867 http://www.medworm.com/index.php?rid=5551866&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03772.x Conclusions:  The incidence of desaturation was higher in patients receiving TAL compared with children who did not. This association should perhaps be considered when contemplating the use of this technique. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5551866 Wed, 28 Dec 2011 05:00:00 +0100 5551866 http://www.medworm.com/index.php?rid=5551865&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03773.x We describe 14 consecutive children who received computed tomography‐guided percutaneous lung biopsy (CT‐PLB) under general anesthesia over an 18‐month period at our institution. Pulmonary hemorrhage (occurring in 36%) and pneumothorax (29%) were the two most common complications; the overall complication rate was 64%. When complications did occur, immediate airway management was facilitated by the presence of an endotracheal tube (ETT). We conclude as follows: (i) CT‐PLB in our series is associated with a high risk of both overall and severe complications; (ii) risk of complications is increased by both patient and procedure‐related factors; (iii) airway management with ETT may be preferable should a complication arise; (iv) severe complications may necessitate ICU admission, wh... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5551865 Wed, 28 Dec 2011 05:00:00 +0100 5551865 http://www.medworm.com/index.php?rid=5551864&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03782.x Conclusions:  Clearance based on empirical allometric scaling predicted unacceptable doses. Theory‐based allometric scaling combined with a maturation function has been confirmed by external evaluation to provide a sound basis for describing clearance and predicting morphine doses in humans of all ages. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5551864 Wed, 28 Dec 2011 05:00:00 +0100 5551864 http://www.medworm.com/index.php?rid=5551863&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03758.x Conclusions:  Communication between the operating room and intensive care staff, regarding postoperative pediatric cardiac patients, significantly improved with the implementation of a structured handover. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5551863 Wed, 28 Dec 2011 05:00:00 +0100 5551863 http://www.medworm.com/index.php?rid=5544028&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03783.x We report the use of unilateral transversus abdominis plane (TAP) catheters for analgesia following single‐sided open lower abdominal surgery when epidural analgesia was undesirable in a series of six low‐weight children. Data collection was done via a retrospective chart review. All catheters attempted were successfully placed with resultant low pain scores and the minimal use of rescue analgesic medications. No complications were reported related to these catheters. TAP catheters, although technically challenging, are feasible for the provision of analgesia for surgeries involving the lower abdominal wall in very small patients. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5544028 Wed, 28 Dec 2011 00:44:34 +0100 5544028 http://www.medworm.com/index.php?rid=5544030&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03778.x Coaxial tomography (CT) and magnetic resonance imaging (MRI) scans are so much part of neurological investigation these days and provide such detailed information that even thorough neurological clinical examination may be neglected. The investigations in common use forty years ago were pneumoencephalography, ventriculography in babies with hydrocephalus, and carotid angiography with the injection of X‐ray contrast to outline the arteries. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5544030 Mon, 26 Dec 2011 05:00:00 +0100 5544030 http://www.medworm.com/index.php?rid=5544029&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03781.x We report the case of a thoracic epidural that migrated inward for six centimeters, associated with loss of analgesic effect. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5544029 Mon, 26 Dec 2011 05:00:00 +0100 5544029 http://www.medworm.com/index.php?rid=5537348&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03776.x Conclusion:  Moderate doses of HES 130/0.42/6:1 for perioperative plasma volume replacement seem to be safe even in neonates and small infants. The probability of serious ADR is lower than 0.3%. Changes in acid–base balance may be decreased when HES is used in an acetate‐containing balanced electrolyte solution instead of normal saline. Caution should be exercised in patients with renal function disturbances and those with an increased bleeding risk. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5537348 Sun, 25 Dec 2011 00:44:09 +0100 5537348 http://www.medworm.com/index.php?rid=5537350&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03760.x We present the case of an 8‐year‐old child with Duchenne muscular dystrophy (DMD) undergoing correction of a severe scoliotic curvature. Near the end of an otherwise unremarkable surgery, he developed severe respiratory compromise associated with respiratory acidosis, hypoxia, and hypotension in the face of a catastrophic decrease in lung compliance. After supine positioning and examination, he was discovered to have ACS, which was treated with laparotomy. Complete recovery occurred after 5 days. This case report should raise awareness of a rare, life threatening, but imminently treatable entity that can accompany scoliosis surgery. The description of this case should be particularly important for pediatric anesthesiologists and orthopedic surgeons who care for patients undergoing co... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5537350 Fri, 23 Dec 2011 05:00:00 +0100 5537350 http://www.medworm.com/index.php?rid=5537349&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03770.x Conclusions:  The pediatric anesthesia risk discussion is very variable. Trainees tend to discuss more specific risks than consultants and a patient’s previous experience of anesthesia was associated with a more limited discussion of anesthesia risk. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5537349 Fri, 23 Dec 2011 05:00:00 +0100 5537349 http://www.medworm.com/index.php?rid=5523865&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03754.x Conclusion:  There was no remarkable change in the overlap index before and after LMA placement in children. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5523865 Thu, 22 Dec 2011 00:44:19 +0100 5523865 http://www.medworm.com/index.php?rid=5659296&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03754.x Conclusion:  There was no remarkable change in the overlap index before and after laryngeal mask airway placement in children. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5659296 Mon, 19 Dec 2011 05:00:00 +0100 5659296 http://www.medworm.com/index.php?rid=5514956&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03767.x Conclusions:  Preoperative AVA shown to parents immediately before induction moderates the increase in anxiety associated with the anesthetic induction of their child. Present results suggest that behavioral characteristics seem better predictors of child’s anxiety during induction than anxiety ratings per se and that anesthetists are better than parents in predicting child’s anxiety during induction. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5514956 Mon, 19 Dec 2011 00:42:42 +0100 5514956 http://www.medworm.com/index.php?rid=5504221&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03766.x Conclusions:  Despite a decrease in CI and preload parameters, the combination of single‐lung ventilation and low‐pressure capnothorax was well tolerated in piglets and could justify further clinical studies to be performed in infants and children focusing on hemodynamic and respiratory changes during VATS. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5504221 Fri, 16 Dec 2011 00:44:23 +0100 5504221 http://www.medworm.com/index.php?rid=5504223&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03751.x SummaryMany ad hoc fasting guidelines for pre‐anesthetic patients prohibit gum chewing. We find no evidence that gum chewing during pre‐anesthetic fasting increases the volume or acidity of gastric juice in a manner that increases risk, nor that the occasional associated unreported swallowing of gum risks subsequent aspiration. On the contrary, there is evidence that gum chewing promotes gastrointestinal motility and physiologic gastric emptying. Recommendations against pre‐anesthetic gum chewing do not withstand scrutiny and miss an opportunity to enhance comfort and sense of wellbeing for patients awaiting anesthesia. Gum chewing during the pre‐anesthetic nil per os (NPO) period would also permit the development of gum‐delivered premedications and should be permitted in childre... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5504223 Thu, 15 Dec 2011 05:00:00 +0100 5504223 http://www.medworm.com/index.php?rid=5504222&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03755.x Conclusions:  We found no differences in child distress, parent satisfaction, and respiratory complications between inductions conducted in the IR vs the OR. Differences in utilization, efficiency, and turnover were minimal and not operationally significant. Capital equipment, space, and staffing strategies should be key drivers in considerations for the use of IRs, and in the design of ORs with IRs. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5504222 Thu, 15 Dec 2011 05:00:00 +0100 5504222 http://www.medworm.com/index.php?rid=5494485&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03756.x Conclusion:  Bispectral index decreased after GHB injection and was correlated with OAAS score. Deep sedation can be safely achieved with IV doses of 25 or 50 mg·kg−1, but the last dose was associated with prolonged duration of clinical sedation. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5494485 Tue, 13 Dec 2011 00:48:05 +0100 5494485 http://www.medworm.com/index.php?rid=5486267&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03757.x Conclusion:  Pediatric size 2 i‐gel is easy to insert and provides higher OSP compared with same size PLMA and cLMA in spontaneously breathing children undergoing elective surgery. It may be a safe alternative to LMA in day care surgeries. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5486267 Sat, 10 Dec 2011 00:49:58 +0100 5486267 http://www.medworm.com/index.php?rid=5476013&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03747.x There are some names that are well known in pediatric anesthesia but who were these people? For 60 years before work stations appeared, the Ayre’s T Piece was widely used. Appropriately initialed, T.P. Ayre (Philip) (Figure 1) was a Newcastle anesthetist who gave several hundred anesthetics as a student, so it was natural that he should become an anesthetist. Ayre’s T Piece was developed about 1937. It allowed fresh gas to be delivered to an endotracheal tube, allowing the anesthetist to be distanced from the operative field. The original T Piece was derived from part of a Phillips airway, which Ayre had been using. It had a bend in the side arm within the lumen of the connecting tube so that the gas could be delivered flowing toward or away from the patient. Ayre soon realized that... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476013 Wed, 07 Dec 2011 00:48:33 +0100 5476013 http://www.medworm.com/index.php?rid=5476016&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03745.x Conclusions:  Our data indicate that PVI is not a surrogate for PPV. PVI measurements were not influenced by changing from the supine to prone position and therefore may prove useful for patients undergoing spine surgery. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476016 Tue, 06 Dec 2011 05:00:00 +0100 5476016 http://www.medworm.com/index.php?rid=5476015&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03750.x Conclusions:  Surgical procedures were seldom associated with the occurrence of perioperative adverse events. However, larger studies are needed to confirm these results. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476015 Tue, 06 Dec 2011 05:00:00 +0100 5476015 http://www.medworm.com/index.php?rid=5476014&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03743.x Conclusions:  In this small group of hospitalized infants, acupuncture was found to be safe, well tolerated, and therapeutic. More studies are warranted to define the role of acupuncture in this population. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476014 Tue, 06 Dec 2011 05:00:00 +0100 5476014 http://www.medworm.com/index.php?rid=5468308&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03731.x The pediatric epidural is an accepted method of advanced analgesia in children. Newer techniques have now superseded pediatric epidural analgesia (PEA), being as effective and safer, especially with the advances in ultrasonography. PEA is, however, still an important technique to master and employ, and it may be that the indications for this mode of analgesia have now become more defined. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5468308 Sun, 04 Dec 2011 00:48:11 +0100 5468308 http://www.medworm.com/index.php?rid=5468307&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03725.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5468307 Sun, 04 Dec 2011 00:47:57 +0100 5468307 http://www.medworm.com/index.php?rid=5449474&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03736.x World Paediatric Anaesthetic meetings (held in relation to World Congress of Anesthesiologists)In 1984, David Steward (in Figure 1, front row) and Seizo Iwai (Figure 2) organized a meeting of pediatric anesthetists in Manila during the World Congress of Anesthesiologists. Following the meeting, there was a dinner at which John Zorab, then Secretary of the World Federation of Societies of Anaesthesiologists (WFSA), told the audience that if they wanted to set up a Paediatric Committee in the WFSA, they should request to do so immediately. A show of hands at this informal occasion showed a majority but not unanimous approval (because no aims and objectives had been defined for the committee). It was established at the WFSA Executive meeting the next day. Eventually, a multiauthored WFSA ha... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5449474 Mon, 28 Nov 2011 00:49:14 +0100 5449474 http://www.medworm.com/index.php?rid=5431232&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03738.x Conclusions:  This audit adds to the data already published about incidences of complications and comorbidities associated with TOF/OA repair. Defining anesthetic practice with regard to ventilation and analgesic strategies is important in comparing the adequacy and risk of techniques used. Our audit shows that a range of differing anesthetic techniques are still employed by different anesthetists and institutions and details some of the techniques being used for managing difficult ventilation. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5431232 Tue, 22 Nov 2011 00:47:02 +0100 5431232 http://www.medworm.com/index.php?rid=5431236&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03726.x This study is a retrospective analysis of perioperative data in infants <6 months of age undergoing herniorraphy during the period November 2007–November 2009. Collected data included age, gestational age at birth, post‐conceptional age, weight, weight at birth, type of anesthesia (spinal vs general), perioperative administration of opioids and paracetamol, duration of surgery, duration of PACU stay, and apnea in PACU. Data analysis used classification and regression trees (CART) with a 10‐fold cross‐validation.Results:  Two hundred and ninety‐six patients were included in the analysis. Five parameters were found to predict the duration of PACU stay: a post‐conceptional age below 45 weeks, prematurity, general anesthesia, postoperative opioid administration, and the us... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5431236 Mon, 21 Nov 2011 05:00:00 +0100 5431236 http://www.medworm.com/index.php?rid=5431235&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03739.x Conclusions:  Although limited by its retrospective nature, this is the first series describing perioperative risk for patients with A‐T. Our results indicate that general anesthesia, airway manipulation, and perioperative mechanical ventilation may be tolerated with only minor postoperative anesthetic concerns. Perioperative providers should be aware of the complex multisystem medical concerns that may arise in these patients. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5431235 Mon, 21 Nov 2011 05:00:00 +0100 5431235 http://www.medworm.com/index.php?rid=5431233&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03737.x SummaryThe strategies used to manage children exposed to long‐term opioids are extrapolated from adult literature. Opioid consumption during the perioperative period is more than three times that observed in patients not taking chronic opioids. A sparing use of opioids in the perioperative period results in both poor pain management and withdrawal phenomena. The child’s pre‐existing opioid requirement should be maintained, and acute pain associated with operative procedures should be managed with additional analgesia. This usually comprises short‐acting opioids, regional or local anesthesia, and adjuvant therapies. Long‐acting opioids, transdermal opioid patches, and implantable pumps can be used to maintain the regular opioid requirement. Intravenous infusion, nurse controlled a... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5431233 Mon, 21 Nov 2011 05:00:00 +0100 5431233 http://www.medworm.com/index.php?rid=5421417&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03735.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5421417 Sat, 19 Nov 2011 00:45:52 +0100 5421417 http://www.medworm.com/index.php?rid=5406831&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03744.x SummaryBrachial plexus blockade in children can be used for a broad spectrum of clinical indications. Nevertheless, these regional anesthetic techniques are still underused in pediatric anesthesia that is mainly because of insufficient descriptions of the particular techniques. Ultrasound guidance enables direct visualization of neuronal and adjacent anatomical structures, the cannula, and the spread of local anesthetic. The most important issue in this context is theoretical background knowledge and intensive training of hand skills. The following review article discusses all relevant aspects of ultrasound‐guided brachial plexus blockade. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5406831 Wed, 16 Nov 2011 15:46:51 +0100 5406831 http://www.medworm.com/index.php?rid=5406832&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03704.x This article reviews the use of abdominal wall blocks in pediatric regional anesthesia. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5406832 Mon, 14 Nov 2011 05:00:00 +0100 5406832 http://www.medworm.com/index.php?rid=5399929&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03732.x Conclusions:  The perioperative opiate requirements of pediatric patients who were successfully weaned after prolonged opiate use were similar to opiate‐naïve patients. A history of prolonged opiate use alone does not necessitate special pain management for future procedures. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5399929 Sun, 13 Nov 2011 00:45:41 +0100 5399929 http://www.medworm.com/index.php?rid=5384192&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03729.x This article will review the role of nerve stimulation in modern regional anesthesia techniques in light of the introduction of ultrasound technology. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384192 Tue, 08 Nov 2011 23:44:23 +0100 5384192 http://www.medworm.com/index.php?rid=5399930&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03727.x Conclusions:  Children intubated with uncuffed ETTs are more likely to have POST. ETT CP is positively correlated with the incidence of POST. When using cuffed ETTs, CP should be routinely measured intraoperatively. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5399930 Tue, 08 Nov 2011 05:00:00 +0100 5399930 http://www.medworm.com/index.php?rid=5384193&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03730.x SummaryWith ultrasound, continuous peripheral nerve blocks (CPNBs) are one of the most recent developments in regional anesthesia in children. CPNBs are now used more widely in children because more suitable materials have been marketed, allowing complete, and prolonged postoperative pain control. Their use after orthopedic procedures in children and treatment for complex regional pain syndrome in adolescents has demonstrated the benefits. Perineural catheters have also shown their superiority over other techniques of continuous regional anesthesia in terms of side effects. The efficiency and the safety of these techniques may facilitate early ambulation with improved pain management, treatment at home with disposable pumps, and improved rehabilitation of children. Studies on large cohorts... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384193 Thu, 03 Nov 2011 04:00:00 +0100 5384193 http://www.medworm.com/index.php?rid=5346717&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03728.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346717 Wed, 26 Oct 2011 02:06:39 +0100 5346717 http://www.medworm.com/index.php?rid=5346716&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03687.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346716 Wed, 26 Oct 2011 02:06:38 +0100 5346716 http://www.medworm.com/index.php?rid=5346715&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03684.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346715 Wed, 26 Oct 2011 02:06:36 +0100 5346715 http://www.medworm.com/index.php?rid=5346714&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03682.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346714 Wed, 26 Oct 2011 02:06:35 +0100 5346714 http://www.medworm.com/index.php?rid=5346713&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03681.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346713 Wed, 26 Oct 2011 02:06:33 +0100 5346713 http://www.medworm.com/index.php?rid=5346712&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03680.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346712 Wed, 26 Oct 2011 02:06:32 +0100 5346712 http://www.medworm.com/index.php?rid=5346711&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03676.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346711 Wed, 26 Oct 2011 02:06:30 +0100 5346711 http://www.medworm.com/index.php?rid=5346710&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03675.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346710 Wed, 26 Oct 2011 02:06:29 +0100 5346710 http://www.medworm.com/index.php?rid=5346709&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03671.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346709 Wed, 26 Oct 2011 02:06:27 +0100 5346709 http://www.medworm.com/index.php?rid=5346708&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03668.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346708 Wed, 26 Oct 2011 02:06:26 +0100 5346708 http://www.medworm.com/index.php?rid=5346707&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03670.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346707 Wed, 26 Oct 2011 02:06:24 +0100 5346707 http://www.medworm.com/index.php?rid=5346706&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03719.x John Inkster died on September 10th 2011. He started life early, weighing only 2 pounds (0.9 kg). The outlook for him and his twin sister was poor so his mother, who was a nurse trained at the Childrens Hospital, Great Ormond Street, took them home to look after them herself. This showed that very small premature babies could survive with special care that did not include all the modern techniques.He was educated at Epsom College and graduated as a doctor from Aberdeen University in 1945. His first job was at Hampstead where they did their ward work in the morning and took over the anesthetics in the afternoon from the anesthetists – a frightening situation as they had no training. He was in the army for 3½ years, still giving anesthetics with little training. In 1950, he went to Ne... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346706 Wed, 26 Oct 2011 02:06:20 +0100 5346706 http://www.medworm.com/index.php?rid=5346705&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03715.x Conclusions:  There is considerable evidence that caudally administered clonidine in addition to local anesthetics provides extended duration of analgesia with a decreased incidence for analgesic rescue requirement and little adverse effects compared to caudal local anesthetics alone. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346705 Wed, 26 Oct 2011 02:06:12 +0100 5346705 http://www.medworm.com/index.php?rid=5346704&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03722.x Conclusions:  This study does not support the routine use of ultrasound for the performance of DPNB in male pediatric circumcision. Nonetheless, an associated reduction in codeine administration postoperatively suggests some benefit in terms of postoperative pain. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346704 Wed, 26 Oct 2011 02:06:10 +0100 5346704 http://www.medworm.com/index.php?rid=5346703&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03700.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346703 Wed, 26 Oct 2011 02:06:01 +0100 5346703 http://www.medworm.com/index.php?rid=5346701&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03713.x Conclusions:  After tonsillectomy, children experience significant pain and severe functional limitation for 7 days after surgery. For many children, pain and functional limitation persists throughout the second postoperative week. In children undergoing orchidopexy, paracetamol and ibuprofen provide adequate analgesia. Pain begins to subside after the first postoperative day, and normal activity resumes after 7 days. After IHR, children experience mild pain that can be treated with paracetamol and return to normal functioning after 4 days. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346701 Wed, 26 Oct 2011 02:05:04 +0100 5346701 http://www.medworm.com/index.php?rid=5346702&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03724.x Charles Robson (Figure 1) was born in New Westminster, British Columbia (now a suburb of Vancouver), in 1884 and graduated in medicine from McGill University in Montreal in 1913. Having interned and with some anesthesia training at the Royal Victoria Hospital in Montreal, he was sent overseas to work in a Canadian Army Hospital where he founded a school to train military anesthetists. Returning to Canada in 1919, he joined the staff of the Hospital for Sick Children in Toronto as chief anesthetist, a position he held until 1951 (1). During most of this time, he was the sole full‐time anesthetist at the hospital; administration of anesthesia at this hospital was not limited to staff anesthetists until 1950 (1).Figure 1.  Dr Charles Robson.Download figure to PowerPoint (Source: Pediatr... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5346702 Mon, 24 Oct 2011 04:00:00 +0100 5346702 http://www.medworm.com/index.php?rid=5334874&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03712.x Conclusion:  Removal of LMA can be safely accomplished without coughing, moving, or any other airway complications at 3.57% endtidal concentrations of desflurane with fentanyl in 50% of anesthetized children. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5334874 Fri, 21 Oct 2011 23:47:15 +0100 5334874 http://www.medworm.com/index.php?rid=5334876&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03701.x SummaryThis review will discuss the use of peripheral nerve blocks of the head and neck and its application to the practice of pediatric anesthesia using simple, landmark based approaches. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5334876 Wed, 19 Oct 2011 04:00:00 +0100 5334876 http://www.medworm.com/index.php?rid=5334875&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03720.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5334875 Wed, 19 Oct 2011 04:00:00 +0100 5334875 http://www.medworm.com/index.php?rid=5313734&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03718.x Conclusion:  Correlations between GAA and TGVw or GFVw in children are best in the RDC position, but not sufficient to predict GFVw with a given GAA. Interpretation of isolated GAA values may be misleading. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5313734 Fri, 14 Oct 2011 23:48:02 +0100 5313734 http://www.medworm.com/index.php?rid=5313736&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03714.x IntroductionInvasive surgery induces a combination of local response to tissue injury and generalized activation of systemic metabolic and hormonal pathways via afferent nerve pathways and the central nervous system. The local inflammatory responses and the parallel neurohumoral responses are not isolated but linked through complex signaling networks, some of which remain poorly understood. The magnitude of the response is broadly related to the site of injury (greater in regions with visceral pain afferents such as abdomen and thorax) and the extent of the trauma. The changes include alterations in metabolic, hormonal, inflammatory, and immune systems that can be collectively termed the stress response. Integral to the stress responses are the effects of nociceptive afferent stimuli on sy... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5313736 Fri, 14 Oct 2011 04:00:00 +0100 5313736 http://www.medworm.com/index.php?rid=5313735&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03716.x The polio epidemic in Copenhagen in 1952 was a significant stimulus to the development of Intensive Care. Eighty‐five percent of the patients with respiratory involvement died despite the use of Cuirass negative pressure ventilators. After some controversy Ibsen, an anesthetist, was consulted. He found that many patients were dying with CO2 retention. He advocated tracheostomy, suction, and ventilation. Owing to the lack of positive pressure ventilators, this was undertaken by students who contributed 167 000 h of hand ventilation. The mortality decreased to 25%. Anesthetists, having special experience with ventilation, became the leaders in the field as Intensive Care developed. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5313735 Fri, 14 Oct 2011 04:00:00 +0100 5313735 http://www.medworm.com/index.php?rid=5313737&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03717.x Conclusions:  Children taking stimulant medication for ADHD, and who ingest medication on the day of surgery, do not appear to have altered BIS or depth of anesthesia at 1 MAC of sevoflurane. These results do not support a recommendation for a change in anesthetic practice for children having ingested stimulants up to the day of surgery, either in terms of increasing the amount of anesthetic given or monitoring of depth. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5313737 Wed, 12 Oct 2011 04:00:00 +0100 5313737 http://www.medworm.com/index.php?rid=5284907&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03686.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284907 Wed, 05 Oct 2011 23:50:24 +0100 5284907 http://www.medworm.com/index.php?rid=5284906&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03664.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284906 Wed, 05 Oct 2011 23:50:23 +0100 5284906 http://www.medworm.com/index.php?rid=5284905&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03663.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284905 Wed, 05 Oct 2011 23:50:21 +0100 5284905 http://www.medworm.com/index.php?rid=5284904&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03658.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284904 Wed, 05 Oct 2011 23:50:19 +0100 5284904 http://www.medworm.com/index.php?rid=5284903&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03651.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284903 Wed, 05 Oct 2011 23:50:17 +0100 5284903 http://www.medworm.com/index.php?rid=5284902&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03642.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284902 Wed, 05 Oct 2011 23:50:16 +0100 5284902 http://www.medworm.com/index.php?rid=5284901&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03641.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284901 Wed, 05 Oct 2011 23:50:14 +0100 5284901 http://www.medworm.com/index.php?rid=5284900&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03640.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284900 Wed, 05 Oct 2011 23:50:12 +0100 5284900 http://www.medworm.com/index.php?rid=5284899&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.3697.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284899 Wed, 05 Oct 2011 23:50:09 +0100 5284899 http://www.medworm.com/index.php?rid=5284898&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03706.x Conclusions:  Regarding the differential diagnosis of metabolic disturbances after pediatric cardiac catheterization, low‐anion gap metabolic acidosis and hyponatremia should be considered as a possible side effect of the administered contrast medium. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284898 Wed, 05 Oct 2011 23:49:58 +0100 5284898 http://www.medworm.com/index.php?rid=5284897&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03650.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5284897 Wed, 05 Oct 2011 23:49:47 +0100 5284897 http://www.medworm.com/index.php?rid=5273045&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03711.x Conclusion:  These preliminary data suggest that substantial postoperative pain is common in children undergoing laparoscopic appendectomy. More studies of postoperative pain outcomes among children undergoing laparoscopic appendectomy and other common pediatric surgical procedures are needed. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5273045 Sat, 01 Oct 2011 04:00:00 +0100 5273045 http://www.medworm.com/index.php?rid=5273047&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03702.x Conclusion:  Penile block provided better analgesia when compared with caudal epidural in children undergoing primary hypospadias repair. Postoperative urethral fistula formation was more likely in children who received caudal epidural. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5273047 Thu, 29 Sep 2011 04:00:00 +0100 5273047 http://www.medworm.com/index.php?rid=5273046&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03707.x Conclusion:  Tramadol in pediatric patients undergoing UGIE provided sedation as efficient as fentanyl with a better hemodynamic and respiratory stability and provided a superior safety and tolerance in younger children. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5273046 Thu, 29 Sep 2011 04:00:00 +0100 5273046 http://www.medworm.com/index.php?rid=5259918&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03710.x Conclusion:  The ILA is a safe and easy‐to‐use supraglottic airway device for intubation with FOB in infants with normal airway. Insertion and removal of ILA are easy with satisfactory oropharyngeal seal and ventilation. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5259918 Wed, 28 Sep 2011 23:46:30 +0100 5259918 http://www.medworm.com/index.php?rid=5259919&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03708.x SummaryQuality assurance and improvement (QA/QI) is a critical activity in medicine. The use of large‐scale collaborative databases is increasingly essential to obtain enough reports with which to establish standards of practice and define the incidence of complications and risk/benefit ratios for rare events. Such projects can enhance local QA/QI endeavors by enabling institutions to obtain benchmark data against which to compare their performance and can be used for prospective analyses of inter‐institutional differences to determine ‘best practice’. The pediatric regional anesthesia network (PRAN) is such a project. The first data cohort is currently being analyzed and offers insight into how such data can be used to detect trends in adverse events and improve care. (Source: Ped... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5259919 Tue, 27 Sep 2011 04:00:00 +0100 5259919 http://www.medworm.com/index.php?rid=5236606&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03705.x SummaryThe use of regional anesthesia is increasingly common in pediatric practice. This review reports the complications and risks in pediatric regional anesthesia. Few large studies reported incidence of complications. However, the different studies have shown that regional anesthesia, when performed properly, carried a very low risk of morbidity in appropriately selected infants and children. In addition, the use of ultrasound‐guided peripheral nerve blockade has shown some promise toward increasing the safety profile of these already safe techniques. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5236606 Wed, 21 Sep 2011 16:32:33 +0100 5236606 http://www.medworm.com/index.php?rid=5236608&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03695.x Conclusions:  Hemodilution results in significant brain hyperemia with increased edema formation, extravascular blood volume, and water mobility after jTBI. Hemodilution results in less cortical damage but did not alter behavior. Hemodilution is likely not to be clinically beneficial following jTBI. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5236608 Tue, 20 Sep 2011 04:00:00 +0100 5236608 http://www.medworm.com/index.php?rid=5236607&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03709.x Conclusions:  Coagulation factor XIII decreased early during major surgery owing to hemodilution. Overall intraoperative FXIII levels remain low despite of transfusion of fresh frozen plasma. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5236607 Tue, 20 Sep 2011 04:00:00 +0100 5236607 http://www.medworm.com/index.php?rid=5224522&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03692.x SummaryLocal anesthetics (LA) block propagation of impulses along nerve fibers by inactivation of voltage‐gated sodium channels, which initiate action potentials (1). They act on the cytosolic side of phospholipid membranes. Two main chemical compounds are used, amino esters and amino amides. Amino esters are degraded by pseudocholinesterases in plasma. Amino amides are metabolized exclusively by the liver. Only amide LAs will be considered in this article. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5224522 Sat, 17 Sep 2011 20:46:23 +0100 5224522 http://www.medworm.com/index.php?rid=5224525&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03696.x Conclusions:  Owing to enhanced clearance and increased central compartment volume of etomidate, smaller (younger) children will require higher etomidate bolus dose than larger (older) children to achieve equivalent plasma concentrations. The dependence of Cl1 and V1 on age does not support weight‐based etomidate dosing in smaller children. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5224525 Thu, 15 Sep 2011 04:00:00 +0100 5224525 http://www.medworm.com/index.php?rid=5224524&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03703.x Conclusions:  The ILA had higher airway leak pressures and superior fiberoptic grades of view when compared with the LMA‐U and can be a suitable alternative to the LMA‐U in children weighing 10–15 kg. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5224524 Thu, 15 Sep 2011 04:00:00 +0100 5224524 http://www.medworm.com/index.php?rid=5224523&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03689.x Conclusions:  In this study, craniosynostotic corrections were associated with large amounts of blood loss and high ABT rates. The amount of ABT could possibly be reduced by appointing a dedicated team of physicians, by using new less‐invasive surgical techniques, and by adjusting anesthetic techniques. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5224523 Thu, 15 Sep 2011 04:00:00 +0100 5224523 http://www.medworm.com/index.php?rid=5224526&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03678.x was a pioneer of Canadian pediatric anesthesia. He was an outstanding man – once met, never forgotten. My only contact with him was at the First Paediatric Anaesthesia Workshop at HSC in Toronto organized by Alan Conn in 1964. He chaired a panel with Jackson Rees from Liverpool and Bob Cope, a gentlemanly senior anesthetist at the Hospital for Sick Children, Great Ormond Street in London. The introduction was followed by ‘We are all enemies,’ a sure start for a vigorous debate. Digby Leigh was born in Jersey, grew up in British Columbia where he attended the University of British Columbia. He moved to Montreal to attend McGill University because there was no medical school in Vancouver. He graduated in 1932 and, like many others, began surgical training at Montreal Children’s befo... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5224526 Wed, 14 Sep 2011 04:00:00 +0100 5224526 http://www.medworm.com/index.php?rid=5207596&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03693.x SummaryEvery anesthetist should have the expertise to perform lumbar puncture that is the prerequisite to induce spinal anesthesia. Spinal anesthesia is easy and effective technique: small amount of local anesthetic injected in the lumbar cerebrospinal fluid provides highly effective anesthesia, analgesia, and sympathetic and motor block in the lower part of the body. The main limitation of spinal anesthesia is a variable and relatively short duration of the block with a single‐injection of local anesthetic. With appropriate use of adjuvant or combining spinal anesthesia with epidural anesthesia, the analgesic action can be controlled in case of early recovery of initial block or in patients with prolonged procedures. Contraindications are rare. Bleeding disorders and any major dysfuncti... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207596 Mon, 12 Sep 2011 17:18:30 +0100 5207596 http://www.medworm.com/index.php?rid=5207597&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03691.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207597 Wed, 07 Sep 2011 04:00:00 +0100 5207597 http://www.medworm.com/index.php?rid=5207598&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03690.x Conclusions:  Adhering to the specific guidelines that are followed at CHB, the mean utilization of scheduled block time was 79%. This was achieved by maximizing workflow in the surgical, anesthesia, and nursing disciplines to shorten turnover time, fill gaps in the elective schedule with emergency procedures, and provide staffing to accommodate cases that extend beyond the scheduled staffed time prior to the reporting period. Simulated models from other pediatric institutions suggest that the optimal utilization of designated time periods in a surgical facility may range from 85% to 90%. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207598 Tue, 06 Sep 2011 04:00:00 +0100 5207598 http://www.medworm.com/index.php?rid=5183094&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03635.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183094 Sat, 03 Sep 2011 12:38:14 +0100 5183094 http://www.medworm.com/index.php?rid=5183093&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03634.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183093 Sat, 03 Sep 2011 12:38:13 +0100 5183093 http://www.medworm.com/index.php?rid=5183092&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03633.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183092 Sat, 03 Sep 2011 12:38:12 +0100 5183092 http://www.medworm.com/index.php?rid=5183091&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03630.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183091 Sat, 03 Sep 2011 12:38:12 +0100 5183091 http://www.medworm.com/index.php?rid=5183090&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03639.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183090 Sat, 03 Sep 2011 12:38:11 +0100 5183090 http://www.medworm.com/index.php?rid=5183089&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03629.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183089 Sat, 03 Sep 2011 12:38:11 +0100 5183089 http://www.medworm.com/index.php?rid=5183088&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03628.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183088 Sat, 03 Sep 2011 12:38:10 +0100 5183088 http://www.medworm.com/index.php?rid=5183087&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03624.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183087 Sat, 03 Sep 2011 12:38:09 +0100 5183087 http://www.medworm.com/index.php?rid=5183086&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03623.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183086 Sat, 03 Sep 2011 12:38:09 +0100 5183086 http://www.medworm.com/index.php?rid=5183085&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03622.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183085 Sat, 03 Sep 2011 12:38:08 +0100 5183085 http://www.medworm.com/index.php?rid=5183084&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03621.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183084 Sat, 03 Sep 2011 12:38:07 +0100 5183084 http://www.medworm.com/index.php?rid=5183083&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03677.x Fifty years ago, a baby born at 24–26 weeks was not considered viable. It was a tragedy for the mother having carried it for so long. I witnessed such an event as a student.The scourge of premature deliveries was the lack of surfactant in many tiny babies. In general, if a premature infant with hyaline membrane disease, as it was called respiratory distress syndrome (RDS), could not maintain a pO2 above 60 mmHg in 100% oxygen, it was not expected to survive. In late 1969, two babies with suspected RDS came to ICU and were treated by the author with the buffer (tris hydroxyl amino methane, [THAM] which reduced both metabolic and respiratory acidosis and did not contain sodium) and an isoprenaline infusion (β1 stimulant and pulmonary vasodilator). The X‐ray appearances of RDS disapp... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183083 Sat, 03 Sep 2011 12:38:06 +0100 5183083 http://www.medworm.com/index.php?rid=5183082&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03662.x (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5183082 Sat, 03 Sep 2011 12:37:59 +0100 5183082 http://www.medworm.com/index.php?rid=5175376&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03688.x Conclusions:  In cardiac arrest caused by bupivacaine intoxication, first‐line rescue with epinephrine and epinephrine + Intralipid® was more effective with regard to survival than Intralipid® alone and vasopressin + Intralipid® in this pig model. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5175376 Tue, 30 Aug 2011 12:33:10 +0100 5175376 http://www.medworm.com/index.php?rid=5160769&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03672.x We present the case of the youngest reported child to have received intrathecal analgesia for terminal care: a 3‐year‐old boy with advanced pelvic rhabdomyosarcoma, whose refractory pain was managed effectively with an intrathecal infusion of bupivacaine and preservative‐free clonidine. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5160769 Sat, 27 Aug 2011 12:38:53 +0100 5160769 http://www.medworm.com/index.php?rid=5142980&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03685.x Conclusions:  This study shows that in one‐fifth to one‐third of the patients, intravenous cannulation required more than one attempt. It is difficult to predict with accuracy the difficulty of intravenous cannulation solely with easily obtainable patient characteristics. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5142980 Sat, 20 Aug 2011 12:37:33 +0100 5142980 http://www.medworm.com/index.php?rid=5142982&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03667.x SummaryA 15 month old boy with a ventricular septal defect (VSD) underwent percutaneous device closure of the VSD. Five days later he collapsed; on arrival to hospital he was asystolic and received prolonged cardio‐pulmonary resuscitation (CPR) with intermittent return of spontaneous circulation (ROSC). He had recurrent episodic complete heart block with no ventricular escape rhythm, associated with loss of cardiac output, unresponsive to transcutaneous pacing. He was transferred to theatre, while receiving CPR, for urgent removal of the VSD device. Estimated total ‘down time’ was 70 min. The device was removed and patch closure of the VSD was performed. He made a full neurological recovery. Device closure of septal defects has become widespread. We discuss the incidence and type of ... Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5142982 Wed, 17 Aug 2011 23:00:00 +0100 5142982 http://www.medworm.com/index.php?rid=5142981&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03683.x Conclusion:  Although current hospital practices related to preventive drug therapy for LCOS in children with OHS are characterized by a marked variability, only few drugs make up the bulk of prescribing practice with milrinone being most commonly used. Therefore, the survey provides information on which drugs to focus research and establish safe and effective drug use. A unified approach is urgently needed to ensure that children with OHS can benefit from evidence‐based care. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5142981 Wed, 17 Aug 2011 23:00:00 +0100 5142981 http://www.medworm.com/index.php?rid=5126072&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03674.x Conclusion:  Insertion of LMA in glaucomatous children is not associated with an increased IOP response or cardiovascular changes. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5126072 Sat, 13 Aug 2011 14:17:41 +0100 5126072 http://www.medworm.com/index.php?rid=5119548&cid=s_28809_5_f&fid=28809&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1460-9592.2011.03654.x Conclusions:  Cystatin C is a sensitive marker of early renal dysfunction following pediatric heart surgery. Variations in bypass parameters, myocardial injury, and ultimately critical oxygen delivery are significantly associated with the degree of renal impairment. (Source: Pediatric Anesthesia) Pediatric Anesthesia journals http://www.medworm.com/rss/comments.php?id=5119548 Fri, 12 Aug 2011 14:38:57 +0100 5119548