Ultrasound-guided quadratus lumborum block compared to caudal ropivacaine/morphine in children undergoing surgery for vesicoureteric reflex
Background Ultrasound guided quadratus lumborum (QL) block is a relatively new regional technique in paediatric abdominal surgery. It is based on the assumption that local anaesthetic spreads from the QL muscle into the paravertebral space providing somatic and possibly visceral pain relief (ie. from bladder spasms). Previous studies have shown that TAP blocks have a […]
A new way to determine correct depth of central venous catheter insertion using a real-time ultrasound guided insertion technique in pediatric patients.
In this paper, the authors have attempted to determine a practical way to predict the ideal CVC depth of insertion using an ultrasound-guided insertion technique. They retrospectively analysed the data from 386 patients with congenital heart defects undergoing surgery. Children had been cannulated using either the right internal jugular vein approach, left supraclavicular approach or […]
Adverse events in radiation oncology: A case series from Wake Up Safe, the pediatric quality improvement initiative
This is a review of data from a voluntary, multicentre registry of paediatric anaesthetic adverse events (USA), looking specifically at remote anaesthesia in radiation oncology. It was looking for patterns of Serious Adverse Events (SAEs) in the hope of producing recommendations for anaesthetic management. There were 6 reported SAEs of 48,578 anaesthetics in radiation oncology […]
Bupivacaine infiltration in children for postoperative analgesia after tonsillectomy
This randomised controlled study investigated whether the use of local anaesthetic infiltration would reduce the need for post-operative opioid compared to tramadol. Children were randomly allocated to receive either 3mg/kg of intravenous tramadol or infiltration of the tonsillar bed with 5mL of 0.25% bupivacaine. All children were operated on using the blunt dissection technique and […]
Caudal epidural blocks in paediatric patients: a review and practical considerations
Caudal blocks remain one of the most frequently used techniques in paediatric anaesthesia that safely and effectively provides analgesia for children undergoing sub-umbilical procedures. This review article summarises our understanding of the technique, from the indications/contraindications to the pharmacological and technical aspects of the block. It is a good summary for the occasional paediatric anaesthetist […]
Propofol Infusion Syndrome: a structured literature review and analysis of published case reports.
This article analysed 168 case reports of propofol infusion syndrome published in 108 papers. The authors have attempted to identify clinical features that are diagnostic for propofol infusion syndrome and associated with mortality. The authors were unable to find a single clinical feature that was found in all the reported cases analysed. Metabolic acidosis (80% […]
RCT of Parent Led exposure to anaesthetic mask to prevent child pre-op anxiety
This was a randomised controlled trial looking the effect of pre-operative exposure to an anaesthetic mask on the anxiety and compliance of children age 4-7 years attending for day surgery under GA with mask induction. A previous study has demonstrated significantly reduced anxiety if the mask exposure was done on the day of admission. The […]
Ultrasound-guided vs. palpation-guided techniques for radial artery catherisation in infants
Summary Randomised controlled trial 74 infants under 12 months of age, undergoing elective cardiac surgery allocated to either ultrasound-guided using short-axis view group (group US) or palpation-guided group (group P) (each n=37) for radial artery catherisation Procedure performed by one of two anaesthetists (each had more than 2 years of experience in paediatric cardiac anaesthesia […]