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Anesthesia pediatric airway

Philip A Sosa, Phillip Matar, Isabel T Gross
BACKGROUND: Extracranial carotid aneurysms in children are extremely rare but carry a high mortality and morbidity. For pediatric patients, they are often complications of pharyngeal infections and surgical trauma but can also arise from congenital and inflammatory diseases. They have a wide range of presentation from an asymptomatic mass to a rapidly fatal hemorrhage. CASE: A 10-year-old boy presented to the emergency department with complaints of a neck mass and residual cough from a recent upper respiratory infection...
February 13, 2019: Pediatric Emergency Care
Jae Young Ji, Jin Soo Park, Ji Eun Kim, Dah Hyung Kim, Jin Hun Chung, Hea Rim Chun, Ho Soon Jung, Sie Hyeon Yoo
BACKGROUND: Sevoflurane is widely used to anesthetize children because of its rapid action with minimal irritation of the airways. However, there is a high risk of agitation after emergence from anesthesia. Strabismus surgery, in particular, can trigger agitation because patients have their eyes covered in the postoperative period. The aim of this study was to determine whether or not esmolol and lidocaine could decrease emergence agitation in children. METHODS: Eighty-four patients aged 3 to 9 years undergoing strabismus surgery were randomly assigned to a control group (saline only), a group that received intravenous lidocaine 1...
February 5, 2019: Chinese Medical Journal
İlknur Yıldırım, Ayça I Çelik, Sema B Bay, Özge Pasin, Ayşe Ç Tütüncü
BACKROUND AND PURPOSE: To investigate the incidence of complications related to propofol-based anesthesia and the factors associated with complications in children with radiotherapy. MATERIALS AND METHODS: Patients who underwent anesthesia for external beam radiotherapy between May 2013 and November 2017 were included in the study. We assessed the age/weight, sex, oncologic diagnosis, type of radiotherapy procedure, duration of anesthesia, applied agents, and complications related to anesthesia...
January 30, 2019: Journal of Oncology Pharmacy Practice
Joseph B Meleca, Samantha Anne, Brandon Hopkins
INTRODUCTION: Choanal atresia (CA) is a rare pediatric congenital disorder resulting in upper airway obstruction and respiratory distress in the setting of obligate nasal breathing in infants. In 2016, a novel technique was reported in the literature utilizing drug-eluting stents to correct CA. However, 2 out of 3 patients in the study required a second operation under general anesthesia. The repeated visits to the operating room for evaluations and debridement under general anesthesia continues to be a concern for increased morbidity and mortality in infants undergoing repair of CA...
January 7, 2019: International Journal of Pediatric Otorhinolaryngology
Thomas Gehrke, Stephan Hackenberg, Bernhard Steinhübel, Rudolf Hagen, Agmal Scherzad
OBJECTIVES/HYPOTHESIS: To evaluate whether endotracheal intubations are superior to the use of laryngeal masks in the airway management for adenoidectomies in pediatric patients in terms of safety and duration of surgery. STUDY DESIGN: Retrospective case series. METHODS: A retrospective analysis of 1,500 adenoidectomies in children using laryngeal mask or endotracheal intubation for intraoperative ventilation between 2009 and 2017. Data collected included complications, duration of surgery, and duration of induction and emergence from anesthesia...
January 10, 2019: Laryngoscope
Sung Hye Byun, Soo Jin Kim, Eugene Kim
BACKGROUND: The insertion of a laryngeal mask airway (LMA) is difficult in children due to the unique features of their airways. Muscle relaxants have been reported to facilitate LMA insertion in adults; however, there is a lack of evidence supporting this in children. This trial is designed to assess the feasibility of LMA insertion with and without the use of muscle relaxants in pediatric patients under general anesthesia. METHODS/DESIGN: This is a prospective, double-blind, single-center, parallel-arm, non-inferiority, randomized controlled trial to be conducted with participants aged 2-7 years who are undergoing elective ophthalmic surgery under general anesthesia...
January 9, 2019: Trials
Ajay Singh, Renu Sinha, Ajisha Aravindan, Kanil Ranjith Kumar, Priyankar Kumar Datta
BACKGROUND: Although sevoflurane is preferred for inhalational induction in children, financial and environmental costs remain major limitations. The aim of this study was to determine if the use of low-fresh gas flow during inhalational induction with sevoflurane could significantly reduce agent consumption, without adversely affecting induction conditions. METHODS: After institutional ethical committee approval, 50 children, aged 1-5 years, undergoing ophthalmic procedures under general anesthesia, were randomized into 2 groups - standard induction (Group S) and low-flow induction (Group L)...
January 4, 2019: Paediatric Anaesthesia
Robert E Christensen, Rebecca C Nause-Osthoff, Jeffrey C Waldman, Daniel E Spratt, Jason W D Hearn
BACKGROUND: Radiation therapy in pediatric patients often requires anesthesia and poses environmental challenges. Monitoring must be done remotely to limit radiation exposure to the provider. Airway access can be limited by masks or frames. Care is often delivered in relatively inaccessible locations in the hospital. While individual institutions have reported their outcomes, this case series aims to review a multicenter registry of significant adverse events (SAE) and make recommendations for improved care...
December 23, 2018: Paediatric Anaesthesia
Sarah B Jacob, Guerin M Smith, Whitney N Rebholz, Elizabeth D Cash, Sasi R Kalathoor, Julie L Goldman, Swapna K Chandran
OBJECTIVE: To determine whether anesthesiologists need to rely on polysomnography (PSG) when predicting need for airway intervention during induction in patients with sleep-disordered breathing (SDB). METHODS: Prospective case-control observational study at a tertiary care pediatric hospital. Children between the ages of 2-17 undergoing tonsillectomy were divided into three groups: those presenting with OSA observed by history and/or physical examination alone (SDB; n = 33), those with OSA determined by preoperative PSG (OSA; n = 32), and a control group (n = 35) undergoing tonsillectomy for recurrent tonsillitis...
November 13, 2018: International Journal of Pediatric Otorhinolaryngology
Masanori Tsukamoto, Hitoshi Yamanaka, Takeshi Yokoyama
OBJECTIVES: The selection of an appropriate size of tracheal tube is important for airway management. For nasotracheal intubation, passing the nasal cavity should be taken into account for the selection of tube size. The aim of this study was to investigate the selection of appropriate size of nasotracheal tube in pediatric patients retrospectively. MATERIALS AND METHODS: The 1-12-year patients underwent dental procedures under general anesthesia intubated nasotracheally...
January 2019: Clinical Oral Investigations
Martin Krebs, Lutz Müller-Lobeck, Roland C E Francis
Airway management is a major competence of clinical anesthesia. Knowledge of available materials and skills in the use of specific methods and techniques are essential and should be trained routinely. In 2011 the scientific working group in pediatric anesthesia (WAKKA) of the German Society for anesthesia and intensive care medicine (DGAI) published a treatment recommendation for the management of the unexpected difficult pediatric airway. Furthermore, a recommendation for the management of the expected difficult pediatric airway is currently being compiled and the draft is available on the WAKKA homepage...
November 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Eunsun So, Hye Joo Yun, Myong-Hwan Karm, Hyun Jeong Kim, Kwang-Suk Seo, Hyunbin Ha
Oronasal fistulae (ONF) could remain after surgery in some patients with cleft palate. ONF ultimately requires intraoral surgery, which may lead to perioperative airway obstruction. Tongue flap surgery is a technique used to repair ONF. During the second surgery for performing tongue flap division, the flap transplanted from the tongue dorsum to the palate of the patient acts as an obstacle to airway management, which poses a great challenge for anesthesiologists. In particular, anesthesiologists may face difficulty in airway evaluation and patient cooperation during general anesthesia for tongue flap division surgery in pediatric patients...
October 2018: Journal of Dental Anesthesia and Pain Medicine
Chang-Hoon Koo, Sun Young Lee, Seung Hyun Chung, Jung-Hee Ryu
The purpose of this study was to compare the incidence of airway complications between extubation under deep anesthesia (deep extubation) and extubation when fully awake (awake extubation) in pediatric patients after general anesthesia. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement standards. The review protocol was registered with the International Prospective Register of Systematic Reviews (registration number: CRD 42018090172)...
October 14, 2018: Journal of Clinical Medicine
Nicholas J Scalzitti, Kathleen M Sarber
Sleep-disordered breathing has a prevalence of 12% in the pediatric population. It represents a spectrum of disorders encompassing abnormalities of the upper airway that lead to sleep disruption, including primary snoring, obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation. Sleep-disordered breathing is the most common indication for adenotonsillectomy, one of the most common procedures performed in children. In recent years, the American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, and the American Society of Anesthesiologists have crafted guidelines to help safely manage children with sleep-disordered breathing...
November 2018: Paediatric Anaesthesia
Michael R King, Christine L Mai, Paul G Firth
The career of Dr Nishan Goudsouzian spanned half a century of pediatric anesthesia. His 50 years saw seminal contributions to the use of neuromuscular blocking agents in children, the development of proton beam therapy and magnetic resonance imaging for pediatric cancer, the introduction of the laryngeal mask airway, an explosion in the volume and depth of knowledge about pediatric anesthesia, the expansion of formal training in pediatric anesthesia, and the widening of academic efforts to improve anesthetic care for children worldwide...
November 2018: Paediatric Anaesthesia
Cristina Manera Dorneles, Gabriel Sartori Pacini, Matheus Zanon, Stephan Altmayer, Guilherme Watte, Marcelo C Barros, Edson Marchiori, Matteo Baldisserotto, Bruno Hochhegger
OBJECTIVE: To evaluate the feasibility of using ultra-low-dose computed tomography of the chest with iterative reconstruction without anesthesia for assessment of pulmonary diseases in children. METHODS: This prospective study enrolled 86 consecutive pediatric patients (ranging from 1 month to 18 years) that underwent ultra-low-dose computed tomography due to suspicion of pulmonary diseases, without anesthesia and contrast. Parameters used were: 80kVp; 15-30mA; acquisition time, 0...
September 17, 2018: Jornal de Pediatria
Nathaniel H Greene, Edmund H Jooste, Dylan P Thibault, Amelia S Wallace, Alice Wang, David F Vener, Roland A Matsouaka, Marshall L Jacobs, Jeffrey P Jacobs, Kevin D Hill, Warwick A Ames
BACKGROUND: In adults undergoing cardiopulmonary bypass surgery, oral intubation is typically preferred over nasal intubation due to reduced risk of sinusitis and infection. In children, nasal intubation is more common and sometimes preferred due to perceived benefits of less postoperative sedation and a lower risk for accidental extubation. This study sought to describe the practice of nasal intubation in the pediatric population undergoing cardiopulmonary bypass surgery and assess the risks/benefits of a nasal route against an oral one...
September 5, 2018: Anesthesia and Analgesia
Jeong Eun Lee, Ji Hyo Kim, Si-Oh Kim
RATIONALE: When patients are intubated and treated with mechanical ventilation, the upper respiratory tract is bypassed by the flow of dry and cold air. To prevent disturbances of airway homeostasis, a heat and moisture exchanger filter (HMEF) has been applied to breathing circuit. PATIENT CONCERNS: A 4-month-old male infant was ventilated with the pediatric HMEF. We report the impact of ignoring the direct influence of a filter containing deadspace in pediatric mechanical ventilation...
August 2018: Medicine (Baltimore)
Mark C Kendall, Dominic V Pisano, Alexander D Cohen, Michelle Gorgone, Zachary L McCormick, Christopher J Malgieri
STUDY OBJECTIVE: To review research highlights of manuscripts published in 2017 that pertain to all aspects of the clinical practice of anesthesiology. DESIGN: Narrative review. SETTING: N/A. MATERIALS: The major themes addressed in this review include recent studies examining airway management, obstetrical and gynecological anesthesia, pediatric anesthesia, cardiac anesthesia, regional analgesia and pain management...
December 2018: Journal of Clinical Anesthesia
Milton Halyson Benevides de Freitas, Luciana Cavalcanti Lima, Tania Cursino de Menezes Couceiro, Maria Célia Ferreira da Costa, Márcio Handerson Benevides de Freitas
BACKGROUND AND OBJECTIVES: Conjoined twins are monozygotic twins physically joined at some part of the body. This is a rare phenomenon, estimated between 1:50,000 to 1:200,000 births. The objective of this report is to present the anesthetic management and the perioperative challenges for a separation surgery. CASE REPORT: Thoraco-omphalopagus twins were diagnosed by ultrasound and were followed by the fetal medicine team of the service. After 11hours of cesarean, the pediatric surgical team chose to separate the twins...
August 7, 2018: Revista Brasileira de Anestesiologia
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