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The effect of intraoperative methadone on postoperative opioid requirements in children undergoing orchiopexy: A randomized clinical trial Pediatr. Anesth. (IF 1.7) Pub Date : 2024-09-22 Camilla G. Uhrbrand, Karsten H. Gadegaard, Asta Aliuskeviciene, Peter Ahlburg, Lone Nikolajsen
BackgroundChildren undergoing outpatient surgery are at risk of inadequate postoperative pain control. Methadone has a long duration of action and an intraoperative dose may provide stable analgesia throughout the postoperative period. Intraoperative methadone has been shown to improve pain control in adolescents but its use for postoperative pain in pediatric patients undergoing outpatient surgery
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Feasibility of bispectral index monitoring during pediatric critical care transport Pediatr. Anesth. (IF 1.7) Pub Date : 2024-09-22 Adam Watson, Francesca Zanetti, Oliver Ross, John Pappachan, Michael J. Griksaitis
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Auricular laser acupuncture as an adjunct for parental anxiety management during children's surgery: A randomized‐controlled study Pediatr. Anesth. (IF 1.7) Pub Date : 2024-09-18 Wenrui Lin, Michelle A. Fortier, Haydee Cortes, Zeev N. Kain, Shu‐Ming Wang, Guann‐Pyng Li
BackgroundPediatric surgery is associated with high levels of anxiety for both children and parents/caregivers. To mitigate anxiety, auricular acupuncture has shown its potential in the perioperative setting. Accordingly, our team developed a wearable prototype auricular laser acupuncture system, AcuHealth V1.0, as a portable acupuncture device and conducted a proof‐of‐concept evaluation with parents
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Editor's picks for the pediatric anesthesia article of the day: June 2024 Pediatr. Anesth. (IF 1.7) Pub Date : 2024-09-18 Melissa Brooks Peterson, Myron Yaster, Justin L. Lockman
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Can learning from military history help us improving neonatal intubation success rates? Pediatr. Anesth. (IF 1.7) Pub Date : 2024-09-10 Lukas P. Mileder
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A review of the perioperative management of direct oral anticoagulants for pediatric anesthesiologists Pediatr. Anesth. (IF 1.7) Pub Date : 2024-09-08 Kara Furman, Andrew Giustini, Joshua Branstetter, Gary Woods, Laura A. Downey
BackgroundAlthough direct oral anticoagulants (DOACs) have been used in the adult population for over a decade, DOACs use has begun to rise in pediatric populations since FDA approval of rivaroxaban and dabigatran, DOACs offer several advantages for pediatric patients, to other anticoagulants, including a similar safety profile, minimal lab monitoring, and ease of administration. The rise in DOAC use
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Perioperative anesthetic management of patients with hypoplastic left heart syndrome undergoing the comprehensive stage II surgery—A review of 148 cases Pediatr. Anesth. (IF 1.7) Pub Date : 2024-09-08 Matthias Müller, Florian Lurz, Thomas Zajonz, Fabian Edinger, Uygar Yörüker, Josef Thul, Dietmar Schranz, Hakan Akintürk
BackgroundPatients with hypoplastic left heart syndrome undergo the comprehensive stage 2 procedure as the second stage in the hybrid approach toward Fontan circulation. The complexity of comprehensive stage 2 procedure is considered a potential limitation, and limited information is available on its anesthetic management. This study aims to address this gap.MethodsA single‐center retrospective cohort
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Medial infraclavicular (costoclavicular) block in children Pediatr. Anesth. (IF 1.7) Pub Date : 2024-09-02 Raghuraman M. Sethuraman
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Optimizing pediatric tonsillectomy outcomes with an opioid sparing anesthesia protocol: Learning and continuously improving with real‐world data Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-30 Jennifer L. Chiem, Amber M. Franz, Elizabeth E. Hansen, Shilpa T. Verma, Taylor F. Stanzione, Leah K. Bezzo, Michael J. Richards, Sanjay R. Parikh, John P. Dahl, Daniel K. Low, Lynn D. Martin
IntroductionThis quality improvement initiative is a continued pursuit to optimize outcomes by iteratively improving our opioid sparing anesthesia protocol for tonsillectomy with or without adenoidectomy at our pediatric ambulatory surgical center through data driven Plan‐Do‐Study‐Act cycles.MethodsFrom 1/2015 through 12/2023, our standardized tonsillectomy protocol underwent nine procedure‐specific
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Preventing hypothermia in infants – Sustainable improvements or the Hawthorne effect? Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-29 Cameron L. Nixon, Kaitlyn J. Kulesus, Kenichi A. Tanaka, Amir L. Butt
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We have come a long way but, I still have questions Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-28 Mc Donnell Conor
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Anesthetic‐sparing effect of dexmedetomidine during total intravenous anesthesia for children undergoing dental surgery: A randomized controlled trial Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-28 Victor C. L. Lee, Randa Ridgway, Nicholas C. West, Matthias Görges, Simon D. Whyte
BackgroundDexmedetomidine, an α2‐adrenergic agonist, reduces propofol and remifentanil requirements when used as an adjunct to total intravenous anesthesia in adults, but studies in a pediatric population are sparse. This study investigates the magnitude of dose‐sparing effects of a postinduction dexmedetomidine bolus on propofol and remifentanil requirements during pediatric surgery.MethodsIn this
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Effect of high‐flow nasal and buccal oxygenation on safe apnea time in children with open mouth: A randomized controlled trial Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-28 Sang‐Hwan Ji, Jung‐Bin Park, Pyoyoon Kang, Young‐Eun Jang, Eun‐Hee Kim, Ji‐Hyun Lee, Hee‐Soo Kim, Jin‐Tae Kim
BackgroundHigh‐flow nasal oxygenation is reported to prolong duration of apnea while maintaining adequate oxygen saturation with the mouth closed. Also, buccal oxygenation is known to have similar effects in obese adults. We compared the effect of these two methods on prolongation of acceptable apnea time in pediatric patients with their mouth open.MethodsThirty‐eight patients, aged 0–10 years were
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Cumulative sum (CUSUM) analysis to assess caudal block performance among anesthesia residents Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-27 Yena Son, Arkadiy Dubovoy, Yaqi Hu
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Advancing infant anesthesia: PEEP's age‐specific impact on atelectasis and apnea time Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-27 Xue Lei
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What an anesthesiologist should know about pediatric arrhythmias Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-16 Michael T. Kuntz, Susan S. Eagle, Aarti Dalal, Marc M. Samouil, Genevieve E. Staudt, Bevan P. Londergan
Identifying and treating pediatric arrhythmias is essential for pediatric anesthesiologists. Pediatric patients can present with narrow or wide complex tachycardias, though the former is more common. Patients with inherited channelopathies or cardiomyopathies are at increased risk. Since most pediatric patients present for anesthesia without a baseline electrocardiogram, the first identification of
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Successful ultrasound‐guided supraclavicular brachial plexus continuous blockade for traumatic amputation of digits in a 3‐year‐old child: A case report Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-11 Ron E. Samet, Stephanie L. Kahntroff, Christopher G. Langhammer, Christopher R. Parrino
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Perioperative Management of Pediatric Combined Heart and Liver Transplantation: A 17 year single center experience Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-08 Manchula Navaratnam, Emma Xi Li, Sharon Chen, Tristan Margetson, Olga Wolke, Michael Ma, Noelle H. Ebel, C. Andrew Bonham, Chandra Ramamoorthy
BackgroundAn increasing number of centers are undertaking combined heart and liver transplantation in adult and pediatric patients with congenital heart disease.AimThe primary aim of this study was to describe the perioperative management of a single center cohort, identifying challenges and potential solutions.MethodsWe conducted a retrospective review of all patients undergoing combined heart and
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Error traps in patients with congenital heart disease undergoing noncardiac surgery Pediatr. Anesth. (IF 1.7) Pub Date : 2024-08-02 Megan Albertz, Richard J. Ing, Lawrence Schwartz, Manchula Navaratnam
Patients with congenital heart disease are living longer due to improved medical and surgical care. Congenital heart disease encompasses a wide spectrum of defects with varying pathophysiology and unique anesthetic challenges. These patients often present for noncardiac surgery before or after surgical repair and are at increased risk for perioperative morbidity and mortality. Although there is no
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Understanding time to peak effect of propofol as sole agent on bispectral index in children aged 2–12 years Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-31 Gil Gavel, Gilbert Koch, Axel Terrier, Andrew Atkinson, Marc Pfister, Thomas Erb
BackgroundThe pharmacodynamics of propofol in children have previously been described with the proprietary bispectral index (BIS) as an effect‐site marker, and it has been suggested that the rate of onset of propofol might be age dependent, that is, a shorter time to peak effect in younger children. However, these analyses were potentially confounded by co‐administered drugs, in particular opioids
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Editor's picks for the pediatric anesthesia article of the day: May 2024 Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-30 Melissa Brooks Peterson, Myron Yaster, Justin L. Lockman
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Ultrasound of the gastric antrum prior to deep extubation Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-30 Stephanie Mai Tran, Humphrey Lam
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Optimisation recommendations from a study on parental choice of accompaniment during children's surgery: Focus on family structure and mental health factors Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-29 Lianwei Zhou, Manling Li, Wenbo Li
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Editor's picks for the pediatric anesthesia article of the day: April 2024 Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-25 Melissa Brooks Peterson, Myron Yaster, Justin L. Lockman
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Clinical experience with remimazolam in pediatric anesthesiology: An educational focused review Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-17 Joseph D. Tobias
Remimazolam is a novel ultrashort‐acting benzodiazepine, which like midazolam, results in sedation, anxiolysis, and amnesia through its agonistic effects on the gamma‐amino butyric acid A receptor. As opposed to midazolam, its unique metabolism is via tissue esterases, which results in a rapid elimination with a limited context sensitive half‐life and prompt dissipation of its effect when administration
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Physiologic time and anesthesia Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-16 Brian J. Anderson, L. Ignacio Cortinez
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Confirmatory, intraoperative, transesophageal echocardiography in an infant with congenital coronary artery anomalies: A case report Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-15 Nadia S. du Plessis, Reitumetse Tladi, Edwin W. Turton
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A novel approach to calculate the required volume of air for bronchial blockers in young children Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-12 Change Zhu, Saiji Zhang, Mazhong Zhang, Rong Wei
IntroductionBronchial blocker balloons inflated with small volumes of air increase balloon pressure, involving a risk of airway injury especially in young children. However, there are no established guidelines regarding the appropriate volumes of air required to provide safe bronchial occlusion.MethodsThis study aimed to introduce a novel method for calculating the amount of air required for safe bronchial
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Comments on Elmitwalli et al ‘Use of high‐flow nasal cannula versus other noninvasive ventilation techniques or conventional oxygen therapy for respiratory support after pediatric cardiac surgery: A systematic review and meta‐analysis’ Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-12 Tim Murphy, Richard Beringer
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Pediatric anesthesia training in Israel and Palestine: Realities versus expectations Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-10 Daniel Kameny, Yazan Zatari, Yahya Aljuba
Israel is a young country with a rather young system of medical education. This educational review serves to illuminate the similarities and differences in the training of a pediatric Anesthesiologist in both Israel and Palestine.
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Keeping tiny bodies warm: A quality improvement triumph Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-10 Gangireddy Sathwik, Manas Ranjan Sahoo
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Perioperative management in pediatric domino liver transplantation for metabolic disorders: A narrative review Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-09 Ahmed Uslu, Nedim Çekmen, Adnan Torgay, Mehmet Haberal
Domino liver transplantation and domino‐auxiliary partial orthotopic liver transplantation are emerging techniques that can expand the liver donor pool and provide hope for children with liver disease. The innovative technique of domino liver transplantation has emerged as a pioneering strategy, capitalizing on structurally preserved livers from donors exhibiting single enzymatic defects within a morphologically
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Effect of positive end expiratory pressure on non‐hypoxic apnea time and atelectasis during induction of anesthesia in infant: A randomized controlled trial Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-09 Eun‐Hee Kim, Jung‐Bin Park, Pyoyoon Kang, Sang‐Hwan Ji, Young‐Eun Jang, Ji‐Hyun Lee, Jin‐Tae Kim, Hee‐Soo Kim
IntroductionThis study aimed to assess the impact of positive‐end‐expiratory pressure (PEEP) on the non‐hypoxic apnea time in infants during anesthesia induction with an inspired oxygen fraction of 0.8.MethodsThis age stratified randomized controlled trial included patients under 1 year of age. Preoxygenation was performed using an inspired oxygen fraction of 0.8 for 2 min. Inspired oxygen fraction
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Overcoming anesthetic challenges in a child with Michel's aplasia undergoing auditory brainstem implantation Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-07 Ashwini Reddy, Nidhi Panda, Babita Ghai, Naresh K. Panda, Mohan Kameswaran, Madubhushi Chakravarthy Vasudevan
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Global perspectives on pediatric anesthesia Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-03 Clyde T. Matava, Dean Kurth
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Power and privilege in pediatric anesthesia Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-02 Hazel Mumphansha, M. Dylan Bould, Betelehem M. Asnake
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Packaging‐induced distortion of tracheal tubes: Implications on airway management Pediatr. Anesth. (IF 1.7) Pub Date : 2024-07-01 Armanullah Khan, Vishnu Narayanan, Renu Sinha
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Global quality improvement programs: One size doesn't fit all Pediatr. Anesth. (IF 1.7) Pub Date : 2024-06-27 George D. Politis, Elizabeth T. Drum, Walid Habre, Adrian T. Bosenberg
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Incidence of complications after nonoperating room anesthesia in children in a low‐ and middle‐income country: A prospective and observational study Pediatr. Anesth. (IF 1.7) Pub Date : 2024-06-26 Anouar Jarraya, Manel Kammoun, Jaouhar Khcharem, Olfa Cherif, Wiem Feki, Zeinab Mnif
IntroductionNonoperating room anesthesia is a growing field of medicine that can have an increased risk of complications, particularly in low‐ and middle‐income countries.AimsThe aim of this study was to describe the incidence of complications after pediatric nonoperating room anesthesia and investigate its risk factors.MethodsIn this prospective observational study, we included all children aged less
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Modified thoracoabdominal nerves block through perichondrial approach (M‐TAPA) for nephrectomy in children Pediatr. Anesth. (IF 1.7) Pub Date : 2024-06-26 Hande Gurbuz, Mursel Ekinci, Ahmet Kaciroglu
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Airway management of facial burn contractures Pediatr. Anesth. (IF 1.7) Pub Date : 2024-06-24 Adam W. Kaplon, Paul G. Firth, Robert L. Sheridan, Christine L. Mai
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Cuffed versus uncuffed endotracheal tubes in neonates undergoing noncardiac surgeries: A randomized controlled trial Pediatr. Anesth. (IF 1.7) Pub Date : 2024-06-23 Khaled Sarhan, Rana Walaa, Ahmed Hasanin, Manal Elgohary, Ramy Alkonaiesy, Kareem Nawwar, Mohamed Elsonbaty, Ahmad Elsonbaty
BackgroundThe efficacy and safety of cuffed endotracheal tubes (ETTs) in neonates are still unclear, this study aimed to assess the efficacy of cuffed versus uncuffed ETTs in neonate undergoing noncardiac surgeries.MethodsNeonates scheduled for noncardiac surgeries were randomized into two groups according to the type of airway device during general anesthesia: cuffed ETT group (n = 60) and the uncuffed
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Absence of pupillary reflex dilation in response to a laryngeal test stimulus may predict safe tracheal extubation in anesthetized children Pediatr. Anesth. (IF 1.7) Pub Date : 2024-06-23 Daniel Abelson, Merlin D. Larson
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Methadone or not for adolescent complex spine surgery: This is the question Pediatr. Anesth. (IF 1.7) Pub Date : 2024-06-23 Eduardo A. Vega, Marcos Rattalino, Fernando R. Altermatt
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The endocrinologist gap: Managing diabetes patients in absence of a specialist. Pediatr. Anesth. (IF 1.7) Pub Date : 2024-06-18 Nabeel Ahmed,Pablo Ingelmo
The treatment of pediatric patients with diabetes is frequently orchestrated within a multidisciplinary framework at tertiary, specialized institutions. In situations where emergent surgery is indicated or when a procedure is scheduled in a facility devoid of an endocrinology service, the onus of managing perioperative glycemic levels may rest with the attending anesthesiologist. The objective of this
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Getting to the basics: A closer look at acetaminophen (paracetamol). Pediatr. Anesth. (IF 1.7) Pub Date : 2024-06-10 Rajeev S Iyer,James Koziol,Harshad Gurnaney
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A retrospective observational cohort study of the anesthetic management and outcomes of pediatric patients with Alexander disease undergoing lumbar puncture or magnetic resonance imaging Pediatr. Anesth. (IF 1.7) Pub Date : 2024-05-31 Jessica A. Berger, Allan F. Simpao, Scott R. Dubow, Heather A. McClung, Geraldine W. Liu, Amy T. Waldman, Elizabeth T. Drum
BackgroundAlexander disease is a rare, progressive leukodystrophy, which predisposes patients to complications under general anesthesia due to clinical manifestations including developmental delay, seizures, dysphagia, vomiting, and sleep apnea. However, study of anesthetic outcomes is limited.AimsOur aim was to describe patient characteristics, anesthetic techniques, and anesthesia‐related complications
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Innovative change not as yet fully integrated in pediatric anesthesia Pediatr. Anesth. (IF 1.7) Pub Date : 2024-05-30 Gillian Lauder, Leora Kuttner
Pediatric hypnosis is an extremely valuable adjuvant therapeutic tool to reduce pain and ameliorate anxiety in children undergoing procedures and pediatric anesthesia. This perspective summarises; why Integrating hypnosis into practice has this potential, some techniques that are particularly useful in this setting, the training oppurtunities to learn more, and recommendations for future pediatric
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Wake Up Safe in the USA & International Patient Safety Pediatr. Anesth. (IF 1.7) Pub Date : 2024-05-29 Rajeev S. Iyer, Nandini Dave, Trung Du, Choon Looi Bong, Yew Nam Siow, Elsa Taylor, Imelda Tjia
Patient safety is the most important aspect of anesthetic care. For both healthcare professionals and patients, the ideal would be no significant morbidity or mortality under anesthesia. Lessons from harm during healthcare can be shared to reduce harm and to increase safety. Many nations and individual institutions have developed robust safety systems to improve the quality and safety of patient care
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Procedural sedation and analgesia in pediatric diagnostic and interventional radiology: An expert DELPHI consensus document developed by the ITALIAN scientific society of anesthesia, analgesia, resuscitation and intensive care (SIAARTI) Pediatr. Anesth. (IF 1.7) Pub Date : 2024-05-29 Maria Cristina Mondardini, Stefano Pezzato, Luisa Meneghini, Rino Agostiniani, Alessandro De Cassai, Ignazio D'Errico, Carmelo Minardi, Raffaella Sagredini, Fabio Sbaraglia, Caterina Testoni, Francesco Toni, Milo Vason, Angela Amigoni
BackgroundChildren undergoing diagnostic and interventional radiology procedures often require sedation to achieve immobility and analgesia if the procedure is painful. In the past decades, leading scientific organizations have developed evidence‐based guidelines for procedural sedation and analgesia in children outside of the operating room. Their recommendations are being applied to procedural sedation
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The use of honey in the perioperative care of tonsillectomy patients—A narrative review Pediatr. Anesth. (IF 1.7) Pub Date : 2024-05-28 Mei F. Yeoh, Aine Sommerfield, David Sommerfield, Britta S. von Ungern‐Sternberg
Tonsillectomy is one of the most common surgical procedures in childhood. While generally safe, it often is associated with a difficult early recovery phase with poor oral intake, dehydration, difficult or painful swallowing, postoperative bleeding, infection and/or otalgia. Better pain management and the availability of more child friendly medications are within the top consumer priorities in perioperative
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INJEX50 could improve the success rate of local anesthesia for arterial cannulation in the pediatric intensive care unit: A randomized, double‐blind, single‐center study Pediatr. Anesth. (IF 1.7) Pub Date : 2024-05-27 Wataru Sakai, Tomohiro Chaki, Shunsuke Tachibana, Yuki Ichisaka, Yuko Nawa, Tomohiro Nawa, Michiaki Yamakage
BackgroundQuick arterial cannulation is required in pediatric emergency situation, which require effective local anesthesia to avoid withdrawal movement. However, pediatric local anesthesia could be difficult because of withdrawal movement. Jet injectors, which are needleless and provide local anesthesia quickly, could be helpful for pediatric local anesthesia during arterial cannulation.AimsThis study
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Pilot data comparing ketofol total intravenous anesthesia versus inhalational anesthesia for flexible scope‐guided nasal intubation in children Pediatr. Anesth. (IF 1.7) Pub Date : 2024-05-26 Preethy J. Mathew, Ankit Rimal, Aakriti Gupta, Neerja Bhardwaj, Sandhya Yaddanapudi, Prema Menon