Effect of neuromuscular block on surgical conditions during short-duration paediatric laparoscopic surgery involving a supraglottic airway.

Study Type and Method This was a single centre randomised control trial conducted at Hunan Children’s Hospital in China. It compared surgical conditions of paediatric patients (<12 years of age) undergoing unilateral laparoscopic inguinal hernia repair with Proseal LMAs either receiving neuromuscular blockade (intervention) or not (control). The primary outcome measure was the Leiden-surgical rating […]

Incidence of post-induction hypoxemia in children and the effect of induction gas composition.

The clinical impact on oxygenation while using other gases with oxygen during an inhalational induction is unknown. The authors reviewed the effects of nitrous oxide, air and oxygen added to volatile during inhalational induction in children (under 18yrs old) retrospectively from an automated information management system. The primary aim was to measure the incidence of […]

Impact of a revised postoperative care plan on pain and recovery trajectory following pediatric tonsillectomy.

Study Type:  Prospective observational cohort study (a follow-on from a previous cohort study from the same institution). Methods:  A previous cohort study of tonsillectomy at Perth Children’s Hospital demonstrated moderate to severe pain postoperatively, with pain lasting a median of 6 days (range 0-23 days) and nausea and vomiting post discharge affecting 8% of patients […]

A practical and ethical toolkit for last-minute refusal of anesthetic in children.

This interesting case review by Massie and colleagues examines the practical and ethical issues relevant to last-minute anaesthetic refusal in children and adolescents. The authors discuss in turn various possible practical responses beyond the essentials of maintaining the child’s comfort, dignity and privacy. These include deferring the case to later the same day, re-scheduling to […]

Prediction of gastric fluid volume by ultrasonography in infants undergoing general anaesthesia

This prospective observational study from South Korea used point-of-care ultrasonography and developed a predictive model for estimating gastric content volume in infants. 200 infants, 12 months of age or younger having a general anaesthetic needing intubation were included in the study. Gastric ultrasound assessment was done post anaesthetic induction, whilst maintaining spontaneous ventilation in order […]

A Novel Perioperative Multidose Methadone-Based Multimodal Analgesic Strategy in Children Achieved Safe and Low Analgesic Blood Methadone Levels Enabling Opioid-Sparing Sustained Analgesia With Minimal Adverse Effects

In the context of a resurgence in interest in the perioperative use of methadone, the authors set about expanding an evidence base for multi-dose perioperative methadone use as compared with single dose intraoperative use in major paediatric surgery as part of enhanced recovery (ERAS). They referred to their previous ‘before and after’ cohort study within […]

Trimmed central venous catheters in pediatric cardiac surgery: Does height or weight correlate with the amount trimmed?

Background Central lines are sometimes trimmed in small paediatric patients while on bypass to obtain optimal catheter tip positioning (SVC-RA junction). Aims, Methods, Outcomes Single centre, retrospective study – Children’s Mercy Hospital, Kansas City, Missouri, USA. Three-year period.  Patients aged 3 months to 8 years with a 4 French 8cm central venous line (CVL). 147 […]