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Herasym, L. M. "Reasonability of general anesthesia in pediatric dental practice." Thesis, БДМУ, 2017. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17311.
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Van, Schoor Albert-Neels. "Paediatric regional anaesthetic procedures clinical anatomy competence, pitfalls and complications /." Pretoria : [s.n.], 2004. http://upetd.up.ac.za/thesis/available/etd07062005-151955.
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Ngu, Katherine P. "Prospective evaluation of dental day case general anaesthetic for children." Thesis, The University of Sydney, 2001. http://hdl.handle.net/2123/4683.
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Snell, Jennifer Miranda. "Pediatric Emergence Delirium in the Postoperative Setting." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3921.
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Emergence delirium (ED), also known as emergence agitation, is a postoperative condition characterized by aberrant cognitive and psychomotor behaviors following general anesthesia. The incidence of ED is 3 to 8 times higher in children 5 years of age or less. There is no standard of nursing practice for managing ED symptoms in the pediatric surgical population. The purpose of this quality improvement project was to address a gap in knowledge needed to inform clinical decision-making when managing ED in the postoperative setting. Using an educational presentation for post anesthesia care unit (PACU) nurses, this project introduced the use of non-pharmacological interventions to mitigate symptoms of ED in the pediatric population as inspired by The Green Star Initiative, an Army program at Fort Carson. The project aim was to describe the effectiveness of ED-specific interventions from the nursing perspective. Using tenets of the Iowa model, this quality improvement project included a needs assessment survey, PowerPoint presentation, parent education leaflet, ED cheat sheet, and a post-intervention survey. Applying the context, input, process, product model for evaluation, this project increased knowledge of ED-specific interventions used by nurses that demonstrates a change in clinical decision-making. PACU nurses rated the interventions 43% effective on pediatric patients. This project addressed the gap in practice by providing structured education on ED, inspiring the use of ED-specific interventions, and promoting readiness to care for the pediatric surgical population. Outcomes add to the nursing literature by introducing ED-specific interventions to manage pediatric ED in facilities nationwide. A social implication of this project is to improve the care of pediatric surgical patients.
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Edmonds, Brandy N. "Prevalence and factors of sibling-recurrent dental treatment under general anesthesia." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5300.
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Objective/Aims: Assess the prevalence of sibling recurrent dental general anesthesia (DGA) at VCU Pediatric Dentistry. Assess factors that contribute to sibling recurrent dental general anesthesia. Methods: The guardian of patients with siblings were provided a questionnaire to assess the prevalence and factors associated with recurrent DGA. Results: A total of 40 families with a child presenting for GA and at least one sibling were included in the study. Of these, 45% had sibling-recurrent GA treatment (20% in one sibling; 25% in 2 or more siblings). Additionally, 13% of the children currently presenting for GA had already been treated under GA, and 15% of the siblings previously treated with GA had recurrent caries after GA. Conclusion: Sibling-recurrent general anesthesia is high at VCU Pediatric Dentistry Clinic. This increased prevalence could be due to parental acceptance and positive experiences with DGA. Dental providers should be pro-active with prevention methods.
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Malafronte, Marialuisa. "Hypnosis versus Anesthesia: a study with children undergoing Magnetic Resonance Imaging procedures." Doctoral thesis, Universitat Rovira i Virgili, 2021. http://hdl.handle.net/10803/672443.
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Fons: Malgrat l'eficàcia reconeguda de la hipnosi en el camp de l'anestèsia, s'han publicat pocs estudis sobre el seu ús en l’entorn pediatric de la Imatge per Ressonància Magnètica (IRM). Aquesta mancança es pot explicar per les dificultats d’aquesta aplicació, com per exemple pel soroll ambiental o la necessitat d'adaptar el procediment segons l’edat dels nens. Les possibles complicacions derivades de l'ús d'anestèsics durant el IRM i la seva difícil gestió fora de la sala d'operacions, justifiquen la nostra atenció en una tècnica alternativa que podria evitar l’anestèsia dels nens.
Objectius: dissenyar un protocol d'hipnosi d'acord amb l'enfocament ericksonià i establir un estudi d'observació prospectiva per comprovar la seva viabilitat en una població pediàtrica sotmesa als IRM. A més voliem veure la seva eficàcia en l’ansietat, el dolor, el consum de drogues, i el risc anestesiològic.
Procediment: Comparem dos grups, un amb anestèsia (50 pacients) i l’altre amb hipnosi (58 pacients). En total van participar 108 nens a l’estudi, donat el consentiment dels pares. L'anàlisi estadístic va incloure les següents proves: Fisher, U- Mann-Whitney per a variables contínues, Wilcoxon i l’Oportunitat relativa.Introducción: A pesar de la reconocida eficacia de la hipnosis en el campo de la anestesia, pocos estudios han sido publicados en el empleo de la Resonancia magnética (RM) en el ámbito pediátrico. Este hecho puede justificarse por una serie de dificultades concretas, como el ambiente ruidoso y la necesidad de adaptar este proceso según las diferentes edades. Las potenciales complicaciones relacionadas al uso de anestésicos durante la realización de la RM, cuyo manejo puede resultar difícil fuera del ambiente seguro del quirófano, justifica nuestra focalización en la necesidad de una técnica alternativa a fin de evitar la anestesia. Objetivos: Diseñar un nuevo protocolo de hipnosis acorde al enfoque Ericksonian y establecer un estudio observacional prospectivo con el fin de comprobar su viabilidad y eficacia sobre la ansiedad, dolor, consumo de fármacos y riesgo anestesiológico en la población pediátrica sometida a procedimientos de RM. Procedimientos: Hemos comparado dos grupos de niños, grupo sometido a anestesia (n=50) o sometido a hipnosis (n=58). Tras obtener el consentimiento informado de los padres un total de 108 sujetos fueron seleccionados
Background: Despite the recognized efficacy of hypnosis in anesthesia, few studies have been published in the pediatric Magnetic Resonance Imaging (MRI) setting. This can be explained by possible specific difficulties, such as the environmental noise and the need for tailoring the procedure according to different ages. The potential complications related to the use of anesthetics during MRI procedures, whose management can be difficult outside the operating room's safer environment, justified our focus on the need for an alternative technique to avoid anesthesia. Objectives: to design a new hypnosis protocol according to the Ericksonian approach and to set up a prospective observational study to check its feasibility and efficacy on anxiety, pain, drug consumption, and anesthesiological risk in a pediatric population undergoing MRI. Procedure: We compared two groups of children who received anesthesia (n=50) or hypnosis (n=58). After obtaining informed consent by parents, a total of 108 subjects were recruited. Statistical analysis included the Fisher's exact test and the U- Mann-Whitney test for continuous variables and the Wilcoxon test and Odds ratio.
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Chan, Yue-sin, and 陳如倩. "Evidence-based clinical guidelines for applying topical anaesthetics to reduce injection pain in healthy children." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193045.
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According to the World Health Organization, life-threatening infectious diseases, even in remote and vulnerable locations, can be minimised through immunisation. Vaccines interact with the immune system to produce an immune response similar to that produced by natural infection. However, about 10% of the population avoid vaccination and other needle procedures because of “needle fear”. Because of the prevalence of injection pain and more concern about the adequacy of pain management, and with the steadily increasing number of recommended childhood immunisation, we identified a need for evidence-based guidelines on pain management to be developed in our local setting through translational nursing practice.
After a critical appraisal of randomised controlled trials and systematic reviews, it is highly recommended that “topical anaesthetics are effective in reducing vaccination pain” (Grade A recommendation, based on level I evidence by SIGN). In order to facilitate practice from evidence, the implementation potential, transferability, feasibility and cost-benefit ratio - has been examined, and an evidence-based guideline has been developed simultaneously for the new practice. With the identification of stakeholders and the development of a communication plan, potential users of the guideline and pilot testing are discussed. Innovation outcomes and their effectiveness are examined and explored. It is expected that, through this translational nursing practice, vaccination induced pain and distress among healthy children can be managed well, according to the best evidence and up-to-date recommendations.published_or_final_version
Nursing Studies
Master
Master of Nursing
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Hawley, Torrey. "Pediatric Obesity and Peri-Operative Adverse Events." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/453.
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Most surgeries and many medical procedures commonly make use of some form of anesthesia to maximize patient comfort and safety. However, all are associated with risks. Obesity and related health care problems are relatively common in anesthesia and also have a negative effect on morbidity and mortality. Trends in pediatric obesity show increases in both the prevalence and risks for the development of other disease. Using the 1997 through 2009 Kids’ Inpatient Database (KID), this study will assess diagnostic codes to identify complications related to anesthesia in the obese pediatric population. Information gained from this study may serve to advance research and the development of anesthetic techniques to improve both safety and overall health for this population.
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Gosnell, Elizabeth Sutton. "Criteria for Treatment of Children Under General Anesthesia by Pediatric Dentists and Parents." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1307403525.
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Lipp, Kelly. "Post-operative Comfort Following Dental Treatment under General Anesthesia." The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1528982978863674.
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Zale, Andrew. "PARENTAL UNDERSTANDING OF ANESTHESIA RISK FOR DENTAL TREATMENT." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2697.
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Purpose: To determine which method of anesthesia risk presentation parents understand and prefer across their demographic variables Methods: As a cross-sectional study, questionnaires were distributed to 50 parents of patients (<7 years of age) in the VCU Pediatric Dental Clinic. Parents were asked of their own and their children’s demographics, previous dental and anesthesia experiences, and anesthesia understanding. Parents were then asked to rate the level of risk of several risk presentations and finally asked which method of risk presentation they most understood or preferred. Data analysis was performed using descriptive statistics, correlation coefficients, likelihood chi square tests, and repeated measures logistic regression. Results: There was no evidence of a differential preference due to gender (P = 0.28), age (P > .9), education (P = 0.39) or whether they incorrectly answered any risk question (P > 0.7). There was some evidence that the three types were not equally preferred (likelihood ratio chi- square = 5.31, df =2, P-value = 0.0703). The best estimate is that 60% prefer charts, 34% prefer numbers, and 36% prefer activity comparisons. There was a relationship between the average relative risk of general anesthesia and age (r = –0.38, P = 0.0070). Younger individuals indicate High risk more often and older individuals indicate Low risk more often. Conclusion: There was no preference of risk presentation type due to gender, age, or education, but there was evidence that each was not equally preferred. Healthcare providers must be able to present the risk of anesthesia in multiple ways to allow for full patient understanding.
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Hollowell, Robert Louis III. "A Survey on the Usage of Articaine Among General and Pediatric Dentists." VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd/951.
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Purpose: The purpose of this study is to determine the impact that the introduction of articaine has had on local anesthetic selection by general and pediatric dentists for use in three different age groups of children.Methods: Using a cross sectional survey design, a questionnaire regarding the use of local anesthetics in children was mailed to a random sample of 500 general dentists from North Carolina, 500 general dentists from Virginia, and all 230 pediatric dentists from North Carolina and Virginia. The 16-item questionnaire included questions regarding the preferred local anesthetic to use in three different age groups, 2-3 years of age, 4-6 years of age, and 7-10 years of age. Furthermore, the questionnaire also included questions specifically on articaine use in the three different age groups and any related side effects. The association between dental practitioner type and anesthetic use was tested using chi-square or Fisher's exact test.Results: A sample of 337 dentists completed the questionnaire. There was no significant difference in preference of articaine except in older patients aged 7-10 years old where general dentists prefer articaine significantly more than do pediatric dentists (28.1% versus 15.9%). Lidocaine with epinephrine was the local anesthetic that was most preferred in all age groups by all practitioners. Pediatric dentists preferred lidocaine more often than general dentists and general dentists preferred lidocaine without epinephrine more often than pediatric dentists. Twenty-one percent of all dentists surveyed have used articaine in children under 4 years of age and 13% list articaine as the preferred local anesthetic for children under 4 years of age.Conclusion: While lidocaine with epinephrine is still the preferred local anesthetic for use in children, the use of articaine in children is very prevalent among general and pediatric dentists. Articaine use becomes more prevalent as the age of the patient increases and many pediatric and general dentists are using articaine in children under four years of age.
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Kerns, Nicholas Matthew. "Pediatric Anatomical Variations and their Implication on the Difficulty of Nasotracheal Intubation." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1408994437.
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Bettex, Dominique Anne. "Indications, impact and cost effectiveness of transesophageal echocardiography in adult and pediatric cardiac anesthesia /." Zürich, 2004. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000253362.
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Lai, Yat-ming, and 黎一鳴. "The use of topical anesthesia to reduce pediatric IV cannulation pain in an emergency department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48335447.
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Intravenous cannulation of pediatric patients is a common procedure in emergency departments. It is a useful tool to facilitate medical investigations and drug administration. However, the pain induced by the procedure can lead to patient distress and bother the nursing and medical procedures afterwards. There are many kinds of topical anesthesia but no relevant evidence-based guideline for their use is available for the emergency departments. This dissertation synthesizes the available evidence in the literature to establish an evidence-based guideline for the use of topical anesthesia to reduce pain caused by pediatric intravenous cannulation in an emergency department. The communication, implementation and evaluation plan are also developed.
A systematic literature review was conducted from 30th August to 2nd September, 2011. A number of electronic databases, including PubMed, CINAHL Plus and Embase were searched. Thirteen eligible randomized controlled trials were identified. They were integrated into a table of evidence and were critically appraised by the SIGN Methodology Checklist. After synthesis of evidence, it is suggested that needleless anesthesia with apparatus assistance significantly reduced pain as early as in five minutes. Patients should however be observed for two hours after the administration of anesthesia for signs of adverse effects.
The implementation potential, in terms of the transferability, feasibility and cost-benefit ratio, was examined. Among the anesthesia devices, the Jet lidocaine device has satisfactory transferability, feasibility and cost-benefit ratio. The evidence is then translated into a practice guideline with the recommendations scored based on the “SIGN 50: A guideline developer’s handbook”.
A fourteen-month implementation plan,including a communication plan, a pilot study and an evaluation plan is developed. The communication phase lasts for three months and the stakeholders including the Chief of Service, Department Operation Manager, Advanced Practice Nurses, frontline healthcare professionals and the pharmacy department are identified. The pilot plan lasts for ten weeks, which includes a two-week training period, a three-week observational period for baseline measurement, a three-week intervention period and an eight-week amendment period. The pilot study collects data regarding the pain level at baseline and identifies unanticipated problems in the guideline. Amendments would be made accordingly and the revised guideline would be sent for ethical approval before the implementation phase.
In the evaluation plan, the primary outcome for the innovation is the level of pain. The secondary outcomes are the admission rate and length of hospital stay. Other outcomes are the satisfaction of healthcare professionals, utilization rate and cost. It is expected that the cannulation pain, admission rate and length of hospital stay would be lower with the application of topical anesthesia.published_or_final_version
Nursing Studies
Master
Master of Nursing
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Orellana, Colleen C. "A Review of Pediatric General Anesthesia Combination Cases in the Special Health Care Needs Population." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1469059968.
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LaLande, Carla. "Comparison of Emergence Behavior in Pediatric Dental Patients Undergoing General Anesthesia with Sevoflurane versus Desflurane." VCU Scholars Compass, 2008. http://scholarscompass.vcu.edu/etd/940.
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Purpose: To determine which maintenance gas (sevoflurane versus desflurane) resulted in a faster emergence from general anesthesia and investigate the patient's emergence agitation. Methods: One group was maintained during general anesthesia with sevoflurane and the other with desflurane. Upon emergence the patient's behavior was evaluated.Results: The average emergence time for desflurane was 9.8; while the average for sevoflurane was 13.98 minutes. Patients who received premedication had an emergence time of 15.43 minutes, while patients who received no premedication emerged after 8.34 minutes.Zofran® was a significant predictor of purposeful actions. Patients were more aware of their surroundings when they received Zofran® compared to patients who did not receive Zofran®.Conclusion: Maintaining with desflurane and not premedicating patients allowed for a faster emergence from general anesthesia. Patients given Zofran® in their IV during the surgery had less emergence agitation then their counterparts.
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Shults, Lawrence. "A Survey of the Usage of Topical Anesthesia Among Dentist." VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/2090.
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Purpose: The purposes of this study were four-fold: 1) to determine the types and effectiveness of various topical anesthetics being used among dentists currently treating children, 2) to determine the types of procedures for which topical anesthetics are being used among children, 3) to understand the awareness and use of a relatively newer compounded topical gel Oraqix (Dentsply Caulk) among children, 4) to understand the adverse reactions to topical anesthesia that are seen among children. Methods: A cross sectional survey was designed, regarding the type, procedural use, effectiveness, and adverse reactions noted among children to various topical anesthetics. The survey sampled n=4933 actively practicing member dentists from a database of willing survey participants obtained from the American Academy of Pediatric Dentistry. The survey consisted of 14-items in multiple choice/answer format. The survey was pilot tested by a committee of faculty, and attached via e-mail with a cover letter containing a direct survey link for the study participants. Surveys were collected, posted, and managed through www.surveymonkey.com. Results: The study received 1255 responses from practitioners who are actively treating children giving an effective response rate of 25%. Of those that participated 94% are Pediatric dentists, 6% General dentists or “Other” specialists who treat children. The majority of respondents (95%) routinely use topical anesthetic, rating it as effective or very effective clinically. The most commonly used topical was 20%-Benzocaine gel with a reported 96% effective rate. The most common procedures topical anesthetics are being used for are pre-injection of local anesthetic and extraction of exfoliating deciduous teeth. Very few of the responding practitioners have ever heard of or used Oraqix gel prior to this survey. Many though, would consider using Oraqix if proven effective. Only 10% of respondents reported an adverse reaction to topical anesthetics, the most common being contact dermatitis or tissue sloughing from prolonged contact, followed by an allergic or aversive reaction to the dyes or flavoring in the topical anesthetic. Conclusions: The overwhelming majority of dentists treating children routinely use topical anesthetics to reduce pain response among children. 20%-Benzocaine gel is the most widely used topical anesthetic being used for dental procedures on children. Adverse reactions to topical anesthetic noted among practitioners treating children are very low but must still be strongly considered as potential life threatening risks if not used appropriately. Many practitioners treating children are still looking for the “ideal” topical anesthetic with improvements in taste, the ability to stay localized, the method of delivery, and improved effectiveness being key areas for future research.
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Melo, Emanuelle Albuquerque Carvalho. "AvaliaÃÃo comparativa em relaÃÃo a dor de crianÃas submetidas à anestesia odontolÃgica com e sem vibraÃÃo." Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=11235.
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O medo e a ansiedade durante os tratamentos odontolÃgicos estÃo na maioria das vezes relacionados à dor do procedimento da anestesia local odontolÃgica. Considerando que existem muitos estudos sobre a atuaÃÃo da vibraÃÃo na analgesia, esta dissertaÃÃo teve por objetivo comparar as reaÃÃes apresentadas por crianÃas ao serem anestesiadas com um dispositivo de anestesia local odontolÃgica que produzia microvibraÃÃes durante o procedimento anestÃsico. Trinta crianÃas, sendo 15 do sexo feminino e 15 do sexo masculino, com idade entre sete e 12 anos submeteram-se a duas sessÃes anestÃsicas, e cada paciente recebeu dois tipos de anestesia: com e sem vibraÃÃo. Um sà pesquisador, odontopediatra, realizou os procedimentos anestÃsicos, que foram filmados e consistiram de anestesias terminais infiltrativas, na regiÃo posterior da maxila. Em razÃo do carÃter multidimensional do medo, ansiedade e dor, utilizou-se uma combinaÃÃo de testes avaliÃ-los, como: O Teste do Medo da CrianÃa (Child Fear Survey Schedule â Dental Subscale â CFSS-DS), Escala de Ansiedade Facial (Facial Anxiety Scale â FAS), Escala Som, Olhos e Movimento (Sound, Eyes and Motor â SEM), Escala Visual AnalÃga â Visual Analogue Scale (VAS) e Escala Frankl. Aplicou-se as escalas em momentos prederteminados, os quais ocorreram antes e apÃs o procedimento anestÃsico. ApÃs a segunda sessÃo anestÃsica, buscou-se saber a preferÃncia das crianÃas quanto ao uso ou nÃo de vibraÃÃo e verificou-se que 90% das crianÃas preferiram a anestesia utilizando-se vibraÃÃo. Houve diferenÃa estatisticamente significante na Escala Visual AnÃloga â Visual Analogue Scale (VAS) na comparaÃÃo das mÃdias (p = 0,04) para um critÃrio de seleÃÃo a um nÃvel de significÃncia de 5%. Dessa forma, conclui-se que o uso da vibraÃÃo pareceu exercer influÃncia positiva sobre a percepÃÃo das crianÃas durante o procedimento de anestesia local, pois a maioria dos participantes da pesquisa optou pelo dispositivo com emprego da vibraÃÃo, atrelando ao fato de que foi verificado que a anestesia local com vibraÃÃo provoca menos dor, segundo a diferenÃa estatisticamente significante da Escala Visual AnÃloga.The fear and anxiety during dental treatments are often related to pain regarding local dental anesthetic procedures. As there are many studies about the effect of vibration on pain analgesia, this thesis aimed to compare whether children anesthetized with a dental anesthetic device that produced micro-vibrations during the anesthetic procedure would behave differently when compared to the regular procedure. Thirty children, aged between 7 and 12 years underwent two sessions of local dental anesthesia each, with and without the vibration device. A single researcher, pediatric dentist, managed the anesthetic procedures that consisted of maxillary infiltration anesthesia and which were recorded on video. Due to the multidimensional nature of fear, anxiety and pain, multiple tests were used to evaluate them, such as Child Fear Survey Schedule â Dental Subscale â CFSS-DS, Facial Anxiety Scale â FAS , the SEM Scale Sound, Eyes and Motor, the Visual Analogue Scale (VAS) and the Frankl Scale. The scales were applied twice, before and after anesthesia. After the second anesthetic session, the preference of the children regarding the use or not of vibration was assessed and it was found that 90% of children preferred anesthesia using vibration. There was a statistically significant difference considering the Visual Analogue Scale (VAS) in the comparison of means (p = 0,04) considering a significance level of 5%. As a result, we concluded that the use of vibration seemed to result in a positive influence on the perception of the children regarding the anesthetic procedure, as almost the totality opted by the device with vibration, which lead us to the conclusion that the use of vibration resulted in a less painful local dental anesthesia.
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Agarwal, Gaurav. "Adverse Anesthesia Outcomes: A Retrospective Study of an Ambulatory Surgical Center versus a Dental Office Setting." VCU Scholars Compass, 2007. http://hdl.handle.net/10156/1532.
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Gonzalez, Leopoldo Palheta [UNESP]. "Incidência de parada cardíaca e mortalidade pediátrica durante a anestesia em hospital universitário de atendimento terciário no período de 2005 a 2010." Universidade Estadual Paulista (UNESP), 2013. http://hdl.handle.net/11449/105635.
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000738127.pdf: 2515853 bytes, checksum: b14e7ea0ddd1cbbc1ade96ae04a05861 (MD5)A população pediátrica apresenta incidência mais elevada de parada cardíaca e de óbito perioperatório em relação à adulta. O objetivo do presente estudo foi avaliar a incidência, os fatores desencadeantes e as causas de parada cardíaca e de óbito em pacientes pediátricos durante a anestesia em hospital universitário de atendimento terciário no período de 2005 a 2010. Por meio de um Banco de Dados, o estudo prospectivo identificou a incidência de parada cardíaca e de óbito em 10.649 anestesias pediátricas. As incidências foram calculadas em relação aos atributos: faixa etária, sexo, estado físico segundo a ASA, tipo de atendimento, especialidade cirúrgica, técnica anestésica empregada e fatores desencadeantes (doença/condição do paciente, cirurgia e anestesia como fator principal ou fator contributivo). Foram identificadas 22 paradas cardíacas na sala de operações em crianças sendo que 11 evoluíram ao óbito. Maiores incidências de parada cardíaca ocorreram em pacientes neonatais e lactentes com estado físico ASA IV e V, em cirurgia de emergência durante anestesia geral ou em cuidados de monitorização e suporte e durante cirurgias cardíaca e vascular. A doença/condição do paciente foi o principal fator de parada cardíaca e de óbito. O índice de letalidade foi maior em crianças de 31 dias a um ano de idade, com estado físico ASA V, em cirurgia de emergência e em pacientes ASA V sob cuidados de monitorização e suporte e relacionado ao fator doença/condição do paciente. Ocorreram três paradas cardíacas por fator anestésico contributivo (2,81:10.000) todas em razão de causas respiratórias. Não houve óbito por fator anestésico. Em hospital de ensino de atendimento terciário, a incidência de parada cardíaca (20,65:10.000 anestesias) e de óbito (10,32:10.000 anestesias) em pacientes pediátricos durante a anestesia foi elevada. A incidência de parada cardíaca...
Perioperative cardiac arrest and mortality incidences in children are higher than in adults. This study aimed to evaluate the incidence, causes, and outcomes of cardiac arrest and death in a pediatric surgical population during anesthesia in a tertiary care university hospital from 2005 to 2010. Cardiac arrest and death incidences during anesthesia in 10,649 anesthetics performed in children were identified from an anesthesia database. Cardiac arrest and death rates were calculated in relation to age, gender, ASA physical status classification, anesthesia provider information, surgical speciality, type of procedure and triggering factors (totally anesthesia-related; partially anesthesia-related; totally surgery-related; or totally child disease/condition-related). There were 22 cardiac arrests and 11 deaths in children during anesthesia. Major cardiac arrest and death incidences were observed in children under one year age; emergency surgery; ASA physical status IV or V; monitoring care and support in ASA V patients; and in cardiac and vascular procedures. Child disease/condition was the major cause of cardiac arrest or death. Lethality calculated rates were higher in 31 days - 1 year age children; emergency surgery; ASA V physical status; monitoring care and support in ASA V patients; and child disease/condition related. There were three cardiac arrests partially anesthesia-related (2,81:10.000). There were no anesthesia-related deaths. Respiratory classified events were the most common causes of anesthesia-related cardiac arrest. Cardiac arrest (20.65 per 10,000 anesthetics) and mortality (10.32 per 10,000 anesthetics) incidences were increased over a 6-year period in a tertiary teaching hospital. Anesthesia-related cardiac arrest incidence was 2.81 per 10,000 anesthetics. There were no anesthesia-related deaths. Major cardiac arrest and death incidences were in children under 1 year age; ASA IV or V ...
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Nordeen, Katherine A. "The Effectiveness of a Preventive Recall Strategy in Children Following Dental Rehabilitation Under General Anesthesia." VCU Scholars Compass, 2015. http://scholarscompass.vcu.edu/etd/3718.
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Purpose: This was a pilot study to assess the impact of a preventive strategy following full-mouth dental rehabilitation (FMDR) under general anesthesia in children with early childhood dental caries.
Methods: Sixty-six patients completed FMDR and were included in the analysis. At the consultation visit, caries risk assessment (CRA) and dental exam information were recorded, and caregivers completed an oral health knowledge (OHK) questionnaire. Patients returned for a post-surgery and recall visit. Caregivers received oral hygiene instructions in a motivational-interviewing style.
Results:At the consultation visit all patients were high risk. At the post-surgery visit, only 47% remained high risk (chi-square P
Conclusions: Preliminary data demonstrates that the preventive strategy is effective in reducing CRA level in children following FMDR.
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Gonzalez, Leopoldo Palheta. "Incidência de parada cardíaca e mortalidade pediátrica durante a anestesia em hospital universitário de atendimento terciário no período de 2005 a 2010 /." Botucatu, 2013. http://hdl.handle.net/11449/105635.
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Orientador: Leandro Gobbo BrazBanca: Norma Sueli Pinheiro Módolo
Banca: Eduardo Toshiyuki Moro
Banca: Marco Aurélio Marangoni
Banca: Artur Udelsmann
Resumo: A população pediátrica apresenta incidência mais elevada de parada cardíaca e de óbito perioperatório em relação à adulta. O objetivo do presente estudo foi avaliar a incidência, os fatores desencadeantes e as causas de parada cardíaca e de óbito em pacientes pediátricos durante a anestesia em hospital universitário de atendimento terciário no período de 2005 a 2010. Por meio de um Banco de Dados, o estudo prospectivo identificou a incidência de parada cardíaca e de óbito em 10.649 anestesias pediátricas. As incidências foram calculadas em relação aos atributos: faixa etária, sexo, estado físico segundo a ASA, tipo de atendimento, especialidade cirúrgica, técnica anestésica empregada e fatores desencadeantes (doença/condição do paciente, cirurgia e anestesia como fator principal ou fator contributivo). Foram identificadas 22 paradas cardíacas na sala de operações em crianças sendo que 11 evoluíram ao óbito. Maiores incidências de parada cardíaca ocorreram em pacientes neonatais e lactentes com estado físico ASA IV e V, em cirurgia de emergência durante anestesia geral ou em cuidados de monitorização e suporte e durante cirurgias cardíaca e vascular. A doença/condição do paciente foi o principal fator de parada cardíaca e de óbito. O índice de letalidade foi maior em crianças de 31 dias a um ano de idade, com estado físico ASA V, em cirurgia de emergência e em pacientes ASA V sob cuidados de monitorização e suporte e relacionado ao fator doença/condição do paciente. Ocorreram três paradas cardíacas por fator anestésico contributivo (2,81:10.000) todas em razão de causas respiratórias. Não houve óbito por fator anestésico. Em hospital de ensino de atendimento terciário, a incidência de parada cardíaca (20,65:10.000 anestesias) e de óbito (10,32:10.000 anestesias) em pacientes pediátricos durante a anestesia foi elevada. A incidência de parada cardíaca ...
Abstract: Perioperative cardiac arrest and mortality incidences in children are higher than in adults. This study aimed to evaluate the incidence, causes, and outcomes of cardiac arrest and death in a pediatric surgical population during anesthesia in a tertiary care university hospital from 2005 to 2010. Cardiac arrest and death incidences during anesthesia in 10,649 anesthetics performed in children were identified from an anesthesia database. Cardiac arrest and death rates were calculated in relation to age, gender, ASA physical status classification, anesthesia provider information, surgical speciality, type of procedure and triggering factors (totally anesthesia-related; partially anesthesia-related; totally surgery-related; or totally child disease/condition-related). There were 22 cardiac arrests and 11 deaths in children during anesthesia. Major cardiac arrest and death incidences were observed in children under one year age; emergency surgery; ASA physical status IV or V; monitoring care and support in ASA V patients; and in cardiac and vascular procedures. Child disease/condition was the major cause of cardiac arrest or death. Lethality calculated rates were higher in 31 days - 1 year age children; emergency surgery; ASA V physical status; monitoring care and support in ASA V patients; and child disease/condition related. There were three cardiac arrests partially anesthesia-related (2,81:10.000). There were no anesthesia-related deaths. Respiratory classified events were the most common causes of anesthesia-related cardiac arrest. Cardiac arrest (20.65 per 10,000 anesthetics) and mortality (10.32 per 10,000 anesthetics) incidences were increased over a 6-year period in a tertiary teaching hospital. Anesthesia-related cardiac arrest incidence was 2.81 per 10,000 anesthetics. There were no anesthesia-related deaths. Major cardiac arrest and death incidences were in children under 1 year age; ASA IV or V ...
Doutor
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Burke, Brian. "A Retrospective Study of Operating Room Utilization and Efficiency in a Pediatric Dental Residency Program." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3367.
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Purpose: The purpose was to assess and understand operating room (OR) utilization and efficiency in a pediatric dental residency program. Methods: A retrospective study was performed using chart extraction from 778 patients completed by both pediatric dentistry faculty (n=7) and residents (n=17) in an ambulatory care setting over a 32 month period (between July 2010 and March 2013). Patterns in OR usage time were determined by documenting various timing metrics (start and stop times for anesthesia, start and stop times for the dental procedure, times for throat pack in and out), noting patient information (age and ASA patient classification status), and creating variables by grouping data by clinical provider type and dental procedure. OR usage time was analyzed using multiple regression to estimate the per-tooth or per-mouth time for each type of procedure. Results: The median procedure time was 75 minutes (range= 1 to 517 minutes). Multiple regression indicated that for the average patient, a faculty member took 63.8 minutes (95% CI = 60.8 to 66.7 minutes) and a resident took 81.9 minutes (95% CI = 78.7 to 85.0 minutes, P<.0001).These results demonstrate that the appropriate scheduling of operating room should be based on the proficiency level of provider as well as the complexity of the dental procedure. Conclusion: This study concludes that pediatric dental operating room planning and scheduling in teaching hospitals should take into account real constraints such as residents’ level of training and skill.
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Ulrici, Johanna. "Atemwegsassozierte Komplikationen bei übergewichtigen und adipösen Kindern in der Anästhesie." Doctoral thesis, Universitätsbibliothek Leipzig, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-86764.
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Übergewicht und Adipositas im Kindes- und Jugendalter sind Gesundheitsprobleme, die auch auf dem Gebiet der Anästhesie zunehmend relevant werden. In der vorliegenden Dissertationsschrift wurde untersucht, inwiefern übergewichtige Kinder und Jugendliche, im Vergleich zu nicht-übergewichtigen, Komplikationen des Atemwegsmanagementes und der Oxygenierung während einer Allgemeinanästhesie aufweisen und welche Bedeutung die Thematik in der deutschen Population für die Kinderanästhesie hat.
Mit Hilfe spezieller Erfassungsbögen wurden folgende Parameter ermittelt und die übergewichtigen mit den nicht-übergewichtigen Studienteilnehmern verglichen: der Mallampati Score, schwierige Maskenventilation und Intubation, die Verwendung eines Atemwegshilfsmittels, der Cormack-Lehane Score und die Anzahl der Intubationsversuche. Daneben wurde die Inzidenz von Atemwegsobstruktionen (Broncho- und Laryngospasmen), Husten als Zeichen der Atemwegsirritation und Sauerstoffsättigungsabfälle um mehr als 10 % des Ausgangswertes erfasst.
Es zeigte sich ein signifikant höherer Mallampati Score und ein signifikant häufigeres Auftreten von Husten (p < 0,05). Alle weiteren Parameter blieben ohne statistisch relevanten Unterschied, obwohl Atemwegshilfsmittel prozentual häufiger bei Übergewichtigen eingesetzt wurden.
Bei einer gesonderten Analyse der in die Studie eingeschlossenen Untergewichtigen zeigte sich eine überraschend gehäufte Inzidenz hinsichtlich der schwierigen Laryngoskopie und einer Reintubation.
Die verschiedenen Ursachen für die vorliegenden Ergebnisse werden in der Promotionsschrift detailliert diskutiert. Es wird insgesamt deutlich, dass nicht alleine Übergewicht und Adipositas ausschlaggebend für Atemwegskomplikationen sind, aber durchaus einen Risikofaktor darstellen. Darüber hinaus scheinen auch untergewichtige Kinder ein erhöhtes Risiko für Atemwegskomplikationen zu habe.
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Faria, António Manuel Augusto de. "Sedação em Medicina Dentária: boas práticas, factos e limites." Master's thesis, [s.n.], 2015. http://hdl.handle.net/10284/5270.
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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina DentáriaA escolha do tema para o presente trabalho de investigação, com vista à conclusão do Mestrado Integrado em Medicina Dentária, tem por objectivo contribuir para, de uma forma séria e clara, dar resposta a uma série de interrogações, ansiedades e situações confusas entre membros da classe dos Médicos Dentistas no que diz respeito às práticas de sedação durante tratamentos médico-dentários. Este tema actual, especialmente no que ao panorama nacional diz respeito, tem vindo a levantar no seio da classe diversas questões no que se refere às diferentes abordagens e aos profissionais que as deverão praticar com segurança, nos diferentes contextos. Foi um objectivo, desde a génese do presente trabalho, que o mesmo contribuísse para o estado da arte da Medicina Dentária portuguesa, ultrapassando a mera formalidade curricular de conclusão de um ciclo de estudos de graduação, mas que permitisse ainda um trabalho sólido a continuidade na investigação a desenvolver futuramente nesta área do conhecimento médico. Optou-se por dividir esta monografia em duas partes. Uma primeira de revisão teórica dos conhecimentos e fundamentos inerentes à sedação, em que são revistos os diferentes tipos de sedação existentes e disponíveis, os graus de sedação existentes, os diversos fármacos e técnicas utilizadas, as indicações e contra-indicações e a sua adequabilidade aos vários pacientes, de acordo com as suas especificidades. Na segunda parte do trabalho, a ambição e o desejo de verificar os conhecimentos dos Médicos Dentistas a exercer em Portugal, no que respeita ao uso de técnicas de sedação na sua prática clínica, conduziu à realização de um trabalho de pesquisa com preenchimento de inquéritos aos profissionais, abordando as técnicas, os conhecimentos e a experiência. Todo este processo foi devidamente aprovado pela Comissão de Ética da Universidade Fernando Pessoa.
The choice of the theme for this research paper, with the main goal to finish my MSc in Dentistry, aims to contribute, in a serious and clean way, to give an answer to some doubts, anxieties and some questions between members of Dentist class relating to sedation practices during dentistry treatments. Nowadays, especially concerned about the national scene, this theme has been raising several questions with regard to different approaches and professionals who need to practice safely in different contexts. Since the beginning of this paper, it was a goal that this one contributed to the state of the art of Portuguese Dentistry, going more far than the simple finish of a formal curricular cycle of graduation’s studies. More than that, intents to be a solid and consistent work to be continued, developing even more the research in this knowledge area of medicine. This work is divided in two parts. The first one is a theoretical review of knowledge and fundamentals involved in sedation, where different types of available and existent sedation techniques are reviewed. Besides that, intents to revise the several sedation degrees, the most frequently used drugs and techniques, indications and contraindications and their suitability to patients, according to their specificities. On the second part of the paper, the ambition and desire to actually verify the knowledge of Dentists about sedation techniques in Portugal and to know if a Dentist recognizes how sedation techniques can be useful in the clinical practice, led to do a research paper with filling out surveys to professionals, addressing the technical, the knowledge and the experience. This whole process has been properly approved by the Ethics Committee of Fernando Pessoa University.
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Van, Hilsen Zachary Xavier. "A Comparison of Emergence Agitation/Delirium in Pediatric Dental Patients with Sevoflurane and using Sevoflurane with a Washout Propofol Technique." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1408974076.
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Leonhardt, Amar Juliane. "Evaluation of success in pediatric dental treatment using nitrous oxide from 2000 to 2005 a.d. at the Geneva Community Children's Dental Clinic /." [S.l.] : [s.n.], 2008. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000254173.
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Carranco, Andrew. "Comparison of Spanish-speaking Parental Understanding Using Two Alternative Consent Pathways." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1561450813970583.
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Cowan, Kirsten. "The Effect of Two Surgeons on Operative Time, Anesthesia Time, and Blood Loss in Pediatric Patients with Neuromuscular Scoliosis Undergoing Posterior Spinal Fusion Surgery." Thesis, The University of Arizona, 2014. http://hdl.handle.net/10150/315824.
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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.Objective The goal of this study was to investigate the effect of using a two attending surgeon approach on operative time, anesthesia time, and estimated blood loss in patients with neuromuscular scoliosis undergoing posterior spinal fusion surgery. Methods This was a retrospective chart review study of patients with neuromuscular scoliosis who underwent posterior spinal fusion surgery at Phoenix Children’s Hospital in 2011 and 2012. Results Results from 70 patients showed a significant reduction in operative and anesthesia times for patients with two attending surgeons as opposed to one. Mean operative time for the two surgeon group was 3 hours 30 minutes (SD = 49 minutes) and was significantly shorter than 4 hours 26 minutes (SD = 1 hour 22 minutes), the mean operative time for the one surgeon group, t (56) =3.44, p = .001. Mean anesthesia time for the two surgeon group was 5 hours 28 minutes (SD = 55 minutes) and was significantly shorter than 6 hours 9 minutes (SD = 1 hour 28 minutes), the mean anesthesia time for the one surgeon group, t (57) = -2.34, p = .023. There was no significant difference in estimated blood loss found between the groups. The mean blood loss for the two surgeon group was 1202.1 ml( SD = 1033.1) versus 1042.1 ml (SD = 959.41) for the one surgeon group, t(68) = .671, p = .50. This pattern of results remained the same in subgroup analysis designed to compare cases with similar severity of presentation. Significance Patients with neuromuscular scoliosis may benefit from a two attending surgeon approach to posterior spinal fusion. More studies are needed to determine modifiable risk factors for excessive blood loss in neuromuscular scoliosis patients as well as to investigate the effect of using a two surgeon approach on specific post-operative complications.
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Bassanezi, Betina Silvia Beozzo 1969. "Construção de um modelo matemático fuzzy para predizer o risco de vômitos pós-operatórios numa população pediátrica oncológica a partir da determinação dos fatores de risco." [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308441.
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Orientadores: Artur Uldesmann, Antônio Gonçalves de Oliveira FilhoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-19T05:11:13Z (GMT). No. of bitstreams: 1 Bassanezi_BetinaSilviaBeozzo_D.pdf: 847548 bytes, checksum: c9637586230bf2f7cf661864b073a7fd (MD5) Previous issue date: 2011
Resumo: A incidência de vômitos pós-operatórios em pediatria ainda é alta, apesar dos avanços da anestesia. A ocorrência de vômitos pós-operatórios gera grande insatisfação nos pacientes e seus familiares, pois compromete a qualidade de vida e recuperação das crianças neste período. A profilaxia de vômitos pós-operatórios tem como primeiro passo identificar os pacientes de risco e o grau deste através de uma pontuação. Até o momento existe apenas uma escala de risco proposta para a população pediátrica a escala de Eberhart baseada numa análise estatística de regressão logística. A lógica fuzzy é uma teoria matemática que reconhece não somente duas possibilidades, verdadeiro ou falso como na lógica clássica, mas graus diferentes de falso e verdadeiro, o que permite uma melhor análise de varáveis contínuas como: idade e tempo de anestesia. Este estudo teve como objetivo desenvolver uma nova escala utilizando a teoria fuzzy para predizer a probabilidade de vômitos pósoperatórios em pacientes pediátricos oncológicos a partir da determinação dos fatores de risco. Foram coletados e analisados dados de 198 pacientes menores de 19 anos. Estes dados foram submetidos inicialmente ao teste qui-quadrado e regressão logística para determinar quais variáveis eram estatisticamente significativas para o risco de vômitos pós-operatórios. Destacaram-se quatro fatores de risco: idade, tempo de anestesia, uso de opióides para analgesia pósoperatória e tipo de cirurgia. A partir destes fatores foi criado um sistema para o cálculo de risco baseado na lógica fuzzy com uma interface computacional. O modelo fuzzy desenvolvido foi comparado com o proposto por Eberhart e mostrou-se mais efetivo para esta população. A interface computacional está disponível para acesso na internet (www.hc.unicamp.br/downloads/VPO/) e é de fácil utilização, sendo capaz de predizer a probabilidade de VPO em crianças com câncer com boa acurácia, possibilitando um melhor planejamento da profilaxia anti-emética
Abstract: Despite impressive advances in the field of anaesthesia, postoperative vomiting (POV) has a higher incidence in children. PONV may decrease children and parental satisfaction after surgeries, and impact on quality of living during recovery. The first rule for rational approach of PONV control is identify the patient at risk using predictive factors. There is only one specific score that predicts POV in children, the Eberhart's score. Fuzzy logic is a mathematical theory that has emerged as a type of logic that recognizes more than simple true and false values and takes into account levels of continuous variables such as age or duration of the surgery. In this study, we developed a fuzzy model to predict the probability of POV in pediatric oncologic patients who underwent surgery. Preoperative potential risk factors for POV in 198 children (0-19 yr old) with malignancies were collected and analyzed. Data analysis was performed with the chi-square test and logistic regression to evaluate probable risk factors for POV. This study found four risk factors: age, time of anesthesia, use postoperative opioids and type of surgery. A system based on fuzzy logic was developed with the risk factors found in the logistic regression, and a computational interface was created to calculate the probability of POV. After the analysis, the model was compared with Eberhart's score in the same population and showed a better performance. The use of the computational interface is available through the internet(www.hc.unicamp.br/downloads/VPO/), it is very easy to use and can predict the chance of POV in children with cancer with good accuracy, allowing better planning for postoperative prophylaxis of vomiting
Doutorado
Fisiopatologia Cirúrgica
Doutor em Ciências
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Hempel, Gunther. "Klinische und ökonomische Vorteile eines Neuromonitorings bei Allgemeinanästhesien für Kinder." Doctoral thesis, Universitätsbibliothek Leipzig, 2010. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-62523.
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In der vorliegenden Arbeit wurden die möglichen klinischen und ökonomischen Vorteile eines Neuromonitorings mit dem BIS-Monitor (BIS-Monitor A-2000™, Version 3.4) bei Allgemeinanästhesien für Kinder, im Alter von 2 – 17 Jahren, untersucht. Die Narkose wurde als TIVA mit Propofol und Remifentanil geführt, wobei die Dosierung von Remifentanil jeweils konstant und die von Propofol variabel war. Die 76 in die Studie eingeschlossenen Kinder wurden randomisiert jeweils einer Untersuchungsgruppe mit und einer Untersuchungsgruppe ohne einem Neuromonitoring mit dem BIS-Monitor zugeteilt. Der Bispektralindex (BIS) wurde bei den entsprechenden Kindern kontinuierlich von der Narkoseeinleitung bis zum Wiedererwachen abgeleitet.
Die Anwendung des BIS-Monitors gestaltete sich problemlos, sodass er sich gut in die klinischen Abläufe integrieren lies. Die Auswertung der Daten erfolgte in 2 Altersgruppen (2 - 6 und 7 - 17 Jahre). Dabei konnte gezeigt werden, dass ein Neuromonitoring mit dem BIS-Monitor in nahezu allen untersuchten Bereichen tendenzielle, bzw. signifikante klinische Vorteile gegenüber einer herkömmlichen Steuerung der Narkose aufweist. Dies gilt auch für den ökonomischen Aspekt, da die durch eine schnellere Ausleitung eingesparten Kosten die Kosten der eingesetzten BIS-Elektroden bei weitem überwiegen.
Diese Arbeit unterstreicht damit einmal mehr den Nutzen und die Notwendigkeit der Weiterentwicklung des Neuromonitorings mit dem BIS-Monitor, oder vergleichbarer EEG-basierter Parameter, im Bereich der Kinderanästhesie.
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Cole, D'Audra M. "Effect of a nominal fee on treatment choices for children needing dental rehabilitation /." VCU Scholars Compass, 2007. http://hdl.handle.net/10156/1688.
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Alexis, Mariana, and Österberg Martin. "Icke-farmakologiska interventioner som reducerar preoperativ oro och ångest hos föräldrar till barn som ska genomgå kirurgi : En systematisk litteraturstudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-102431.
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Bakgrund: Hälften av samtliga föräldrar upplever ångest inför att barnet ska genomgå anestesi. Preoperativ oro och ångest hos föräldrar kan exempelvis bero på att operationsmiljön upplevs skrämmande och att barnet kan tänkas uppleva smärta under vårdförloppet, men kan även relateras till anestesiinduktion och den separation från barnet som uppkommer härvid. Den ångest som föräldrar upplever kan överföras och inverka negativt på barnet. Syfte: Syftet var att undersöka tillgängliga interventioner samt deras effekt med avsikten att reducera preoperativ oro och ångest hos föräldrar till barn som ska genomgå kirurgi. Metod: En systematisk litteraturstudie genomfördes där 12 kvantitativa originalstudier söktes fram i databaserna Cinahl, Pubmed och PsycInfo, vilka kvalitetsgranskades och systematiskt analyserades. Relevanta resultat ur artiklarna extraherades i enlighet med Bettany-Saltikov och McSherry där avsikten var att via syntetisering generera föreliggande studies resultat. Resultat: Den systematiska litteraturstudien påvisar att preoperativa förberedelser i form av Undervisning via digitala hjälpmedel, Distraktion via lek, humor och musik, Förberedelser via preoperativ information samt Kombinerad preoperativ undervisning, medicinsk lek och rundvandring är interventioner som reducerar preoperativ oro och ångest hos föräldrar. Slutsats: Resultatet påvisade att flera interventioner hade en reducerande effekt avseende preoperativ oro och ångest hos föräldrar, men därtill att interventioner måste vara individuellt anpassade och i tillräckligt hög grad vara riktade till föräldrar för att erhålla önskvärd effekt.Background: Half of all parents experience anxiety before the child undergoes anesthesia. Preoperative worry and anxiety in parents may, for example, be due to the fact that the surgical environment is experienced as frightening and that the child may experience pain during the course of care, but may also be related to anesthesia induction and the separation from the child that arises. The anxiety that parents experience can be transmitted to and cause negative effects on the child. Aim: The aim was to examine available interventions and their effects regarding intention of reducing preoperative worry and anxiety in parents of children undergoing surgery. Method: A systematic literature review was conducted where 12 quantitative original studies were applied from the databases Cinahl, Pubmed and PsycInfo, which were quality checked and systematically analyzed. Relevant results from the articles were extracted in accordance to Bettany-Saltikov and McSherry where the intention was to generate the results of this review by synthesization. Results: The systematic literature review demonstrates that preoperative preparations in terms of Teaching by digital aids, Distraction by play, humor and music, Preparation by preoperative information and Combined preoperative teaching, medical play and tour are interventions reducing preoperative worry and anxiety in parents. Conclusion: The results demonstrate that several interventions had a reducing effect regarding preoperative worry and anxiety in parents, but in addition that interventions must be individually customized and sufficiently directed at parents to obtain the desired effect.
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Ajnhorn, Fabiana. "Comparação entre dois modos ventilatórios em anestesia pediátrica : ventilação controlada a volume versus ventilação controlada a pressão." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2006. http://hdl.handle.net/10183/8758.
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Justificativa e Objetivos: Comparar as repercussões na mecânica respiratória e na troca gasosa em pacientes pediátricos submetidos à cirurgia ortopédica em posição lateral sob anestesia geral, utilizando-se dois modos de ventilação mecânica: controlada a volume (VCV) versus controlada a pressão (PCV), pois, em anestesia, o benefício de um modo em relação ao outro não está bem estabelecido. Método: Ensaio clínico randomizado, realizado entre julho de 2003 e junho 2005 envolvendo crianças (seis meses a 5 anos) submetidas à cirurgia de correção de pé torto congênito no Hospital de Clínicas de Porto Alegre. No modo VCV o volume corrente para se obter 10ml.kg-1 foi fixado. No modo PCV a pressão de pico inspiratória para se obter 10 ml.kg-1 foi fixada. Nos dois modos os pacientes recebiam PEEP 5cmH2O e relação I:E 1:2. Os grupos foram comparados quanto aos efeitos na mecânica ventilatória e na troca gasosa em 4 momentos ao longo da cirurgia com duração de 2 a 3 horas. Os testes t de Student, ANOVA, e Quiquadrado foram utilizados para comparar os grupos. Resultados: 37 cirurgias de correção de pé torto congênito entraram no estudo, sendo 18 no grupo VCV e 19 no PCV. Observou-se redução do volume corrente expirado ao longo da cirurgia em ambos grupos: VT em M1 ~119 ml enquanto em M4 foi ~113 ml (p=0,03), correspondendo a uma redução de 5% no VT ao longo da cirurgia. O número de intervenções (ajustes na freqüência respiratória) ao longo do tempo cirúrgico foi semelhante nos dois grupos. As demais variáveis não diferiram. Conclusões: durante anestesia geral, em crianças saudáveis, o modo ventilatório não influenciou a estabilidade cardioventilatória das crianças ao longo do tempo cirúrgico no presente estudo.Objectives: To compare the repercussions on the respiratory mechanics and on the gaseous exchange of pediatric patients submitted to orthopedic surgery in lateral position under general anesthesia using two modes of ventilation: volume control ventilation (VCV) versus pressure control ventilation (PCV), because, in anesthesiology, the superiority of one over another is not well established. Methods: Randomized clinical trial, conducted from July of 2003 through June 2005, involving children (from 6 months to 5 years of age) submitted to surgery of correction of congenital clubfoot in the Hospital de Clínicas de Porto Alegre. In the VCV mode, tidal volume to get 10ml.kg-1 was fixed. In the PCV mode, peak inspiratory pressure to get 10 ml.kg-1 was fixed. In the two ventilations modes the patients received a PEEP of 5cmH2O and relation I:E 1:2. The groups were compared in relation to the effect in the mechanical ventilatory support and the gaseous exchange at 4 times through surgery with duration of 2 the 3 hours. Student t Test, ANOVA, and Qui-square had been used to compare the groups. Results: 37 surgeries of correction of congenital clubfoot were included in study, being 18 in the VCV group and 19 in the PCV. Reduction of the exhaled tidal volume along of the surgery in both groups was observed: VT M1 ~119 ml while in M4 was ~113 ml (p=0,03), corresponding to a reduction of 5% in the VT through the surgery. The number of interventions (adjustments in the respiratory frequency) along the surgical period was similar in the two groups. Remaining variables had not differed. Conclusions: In the present study, envolving healthy children submitted to the general anesthesia using two modes of mechanical ventilation, we did not observed any interferency in the cardio respiratory stability along the surgical period.
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Mackenzie, Matthew Robert. "Understanding anesthesia's role in the unplanned admission of pediatric ambulatory surgical patients." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12496.
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Thesis (M.A.)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.Introduction: Pediatric ambulatory surgery has experienced a surge in popularity as new surgical and anesthetic techniques have made it a more viable option for a host of surgical procedures. While the vast majority of patients are successfully discharged upon recovery from anesthesia, a small proportion 1-2.5% in previous studies must be admitted to the hospital's inpatient unit. Many of these patients present with conditions such as uncontrollable post-operative pain and nausea and vomiting associated with anesthesia. As such we sought to characterize the unplanned admissions population at Children's Hospital Boston, a tertiary care pediatric hospital and investigate Anesthesia's role in their care. Methods: Patients were identified as possible candidates for inclusion into this study if they experienced a status change in the Children's Hospital Boston records system from "Day Surgery Unit" to "Inpatient Unit". Data from these patients was gathered using Anesthesia records, medical record number summaries, growth charts, and other electronic medical records. Results: The unplanned admission rate at Children's Hospital Boston was 1.29% from January 2010 through June 2011, representing 347 patients from a day surgery population of 26,951. No statistically significant differences were observed in regards to patient fitness, as measured by American Association of Anesthesiologist classification, when compared to patients successfully discharged. The leading causes of admission were uncontrollable postoperative pain (n=117, 39.8%) and post-operative nausea and vomiting (n=94, 32.0%). When compared to the successfully discharged patient population; orthopedic surgery experienced a statistically significant increase in its contribution rate while genitourinary surgery experienced a statistically significant decrease. Pre-operative acetaminophen usage was only 19%, while midazolam pre-medication was 51.4%. Regional anesthesia was utilized in only 11.5% of cases overall and 27.3% of orthopedic patients. Patients experiencing post-operative nausea and vomiting were primarily treated with ondansetron and dexamethasone as prophylaxis while overwhelmingly receiving a re-dosing of ondansetron post operatively. Post-operative utilization of metaclopramide in these patients was 3.7%. Conclusion: At Children's Hospital Boston 71.8% of unplanned admissions are either for pain or nausea and vomiting, two conditions that are intimately related. It is reasonable to presume that an increased emphasis on prophylaxis analgesia in the form of pre-operative acetaminophen and regional anesthesia would help alleviate a portion of these cases directly related to uncontrollable pain. It is also not unreasonable to assume that these options may decrease post-operative opioid usage, a significant risk factor for post-operative nausea and vomiting. In cases where nausea and vomiting is still present and patients have received ondansetron and dexamethasone intraoperatively, there seems to be a reliance on re-dosing with ondansetron, whereas based on physiological pathways of nausea patients, a third drug-class may be a better option. Improvements in these areas could decrease the unplanned admission rate at Children's Hospital Boston.
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Marciniak, Bruno. "Etude epidemiologique de l'anesthesie dans le service de chirurgie infantile du centre hospitalier regional de lille." Lille 2, 1992. http://www.theses.fr/1992LIL2M188.
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ANDRE, HUGUET VERONIQUE. "L'anesthesie peridurale vue par le pediatre et l'enfant." Aix-Marseille 2, 1988. http://www.theses.fr/1988AIX20535.
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Vieira, José João Moura. "Ansiedade pré-cirúrgica em crianças : avaliação da eficácia de um programa cognitivo-comportamental para a sua redução." Master's thesis, Faculdade de Ciências Médicas. Universidade Nova de Lisboa, 2009. http://hdl.handle.net/10362/4853.
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Este estudo teve como objectivo avaliar a eficácia de uma sessão de informação a propósito de uma intervenção cirúrgica com anestesia geral na redução da ansiedade em jovens com idades compreendidas entre os 6 e os 12 anos. A amostra foi constituída por 125 jovens, 62 do sexo masculino e 63 do sexo feminino. Foram constituídos dois grupos, em que ao grupo experimental foi administrado um programa de informação sobre procedimentos cirúrgicos com anestesia geral, utilizando técnicas de modelagem, e em que ao grupo de controlo apenas foi aplicada a sessão avaliativa. Os resultados obtidos permitiram concluir que a eficácia da sessão informativa a propósito de uma intervenção cirúrgica com anestesia geral na redução da ansiedade, nas crianças, foi comprovada.
The aim of this study was to evaluate the efficacy of an information session about cirurgy, with general anesthesia induction, in reducing anxiety in children from 6 to 12 years undergoing cirurgy. Our sample was constituted by 125 children, 62 boys and 63 girls divided in two groups: the experimental group had an information session about chirurgical procedures with general anesthesia and had anxiety evaluated pre and post session, as the control group had only one anxiety evaluation. The results show that the session was effective on reducing pre-operatory anxiety in children.
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Colven, William Preston DDS. "A Pilot Study of Kovanaze Anesthetic In Children Age 6-8." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1560425557327697.
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REZAIGUIA, SAIDA. "Le masque larynge en pediatrie : risque de regurgitations ; experience du service de chirurgie pediatrique du chru du reims." Reims, 1993. http://www.theses.fr/1993REIMM077.
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Followell, Timothy B. "Effect of Dental Treatment on Parental Stress as Measured by the Parenting Stress Index." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1276567183.
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BRODIER, CATHERINE. "Anesthesie pour chirurgie des fentes labio-palatines en pediatrie : interet de l'isoflurane dans une etude comparee : a propos de 100 cas." Reims, 1989. http://www.theses.fr/1989REIMM093.
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Thomas, Alyssa. "The Evaluation of Pre-incisional and Post-closure Local Anesthetic vs. Normal Saline on Postoperative Pain in Pediatric Appendectomies." Thesis, The University of Arizona, 2018. http://hdl.handle.net/10150/626898.
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Haffner, John. "THE EVALUATION OF PAIN EXPERIENCED BY CHILDREN UNDERGOING SIMPLE EXTRACTION USING 2% LIDOCAINE VERSUS ORAQIX TOPICAL ANESTHETIC GEL." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1719.
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Purpose: The purpose of this study is to examine the pain response experienced by children undergoing simple tooth extractions using 2% Lidocaine injection versus Oraqix topical anesthetic gel. Methods: This study is being conducted at VCU pediatric dentistry clinic. The sample size will consist of 15 children ages 7-12 undergoing a simple extraction procedure. Each participant is randomly assigned to one of two groups, the lidocaine injection group or the Oraqix topical group. The pain level will be measured at four key events during the procedure. The first event will evaluate the pain at baseline. The second event will measure pain during the anesthetic injection or Oraqix topical gel application. The third event will record the response after the tooth has been extracted and the final event will evaluate pain five minutes post operatively. The children are asked to rate their pain using the Facial Pain Scale after all four events. The dentist and an independent observer watching a video of the extraction will also examine and rate the pain responses of each child at each of the four events. Results: The first two participants received lidocaine injection and experienced some pain upon injection. This pain was supported by what the dentist rated as well. One child felt pain on extraction and the other felt nothing. The dentist rated both children as feeling pain. The Oraqix child felt nothing upon application but felt pain during the extraction and post-operatively. The dentist rated the child as feeling nothing during the entire procedure. Conclusions: It appears that the lidocaine injection group’s pain rating matches the pain rating given by the dentist. The Oraqix patient experienced no pain upon application, but did feel pain upon extraction and five minutes post-op. The dentist’s rating contradicted this by rating the child as feeling no pain through the entire procedure. This study is limited by the number of participants and needs more patients to further evaluate other children’s pain responses.
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Carlos, Ricardo Vieira. "Efeito da estimulação tetânica, prévia à calibração, no início de ação e tempos de recuperação do bloqueio neuromuscular em pacientes pediátricos." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5152/tde-14032018-115705/.
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Introdução e objetivos: a monitorização neuromuscular objetiva é prática médica baseada em evidências e deve ser empregada rotineiramente quando do uso de fármacos bloqueadores neuromusculares. Entretanto, pesquisas relacionadas a esta monitorização em pacientes pediátricos não estão vastamente documentadas como nos adultos. Em pesquisa clínica, o monitor neuromuscular deve apresentar resposta estável (menor que 5% de variação na altura de T1) por um período de dois a cinco minutos antes da administração do bloqueador neuromuscular. O tempo necessário para se alcançar esta estabilidade na resposta pode variar, mas pode ser encurtado por meio da aplicação de um estímulo tetânico por cinco segundos. Aventouse a hipótese de que a aplicação de estímulo tetânico antes da calibração poderia levar a diferenças nos parâmetros de início de ação e nos tempos de recuperação. O objetivo primário deste estudo foi comparar o tempo de início de ação e os tempos de recuperação após dose única de rocurônio 0,6 mg/kg seguido de recuperação espontânea, entre dois grupos de pacientes com sequências diferentes para a calibração (com e sem o uso de estímulo tetânico). Os objetivos secundários foram a avaliação da altura inicial e final de T1, tempo para se obter estabilidade da altura de T1 e os seguintes ajustes do monitor neuromuscular: corrente elétrica e sensibilidade. Método: consentimento informado dos responsáveis, foram incluídos no estudo 50 pacientes, estado físico 1 ou 2, de dois a 11 anos, agendados para cirurgias abdominais e/ou perineais com tempo cirúrgico estimado superior a 60 minutos. Os pacientes (25 por grupo) foram submetidos a anestesia intravenosa e alocados randomicamente para receber estímulo tetânico (grupo T) ou não (grupo C), antes da calibração do monitor. Após a calibração do monitor, a modalidade sequência de quatro estímulos foi iniciada e mantida em intervalo de 15 segundos. Resultados: não houve diferença significativa no início de ação (C: 57,5±16,9 versus T: 58,3±31,2 s; p=0,917). O tempo normalizado para as relações da sequência de quatro estímulos 0,7, 0,8 e 0,9 diferiram significativamente entre os grupos (C: 40,1 ± 7,9 versus T: 34,8±10 min; p=0,047, C: 43,8±9,4 versus T: 37,4±11 min; p=0,045 e C: 49,9±12,2 versus T: 41,7±13,1 min; p=0,026, respectivamente). O tempo necessário para a estabilização da altura de T1 não mostrou diferença estatística entre os grupos (C: 195±203 versus T: 116±81,6 s; p=0,093). Os valores de altura inicial de T1 mostraram diferença significativa entre os grupos (C: 98 versus T: 82,7%; p < 0,001). Os valores de altura final de T1 também mostraram diferença significante entre os grupos (C: 95,3 versus T: 69,3%; p < 0,001). Conclusões: o estímulo tetânico encurtou o tempo normalizado das relações da sequência de quatro estímulos 0,7, 0,8 e 0,9. As alturas inicial e final de T1 foram menores no grupo tétano. Não houve diferença estatística entre os grupos relativo ao tempo necessário para estabilização da altura de T1. Os ajustes do monitor (corrente elétrica e sensibilidade) não apresentaram diferenças entre os gruposEffect of tetanic stimulation, prior to calibration, on the onset of action and recovery times of neuromuscular blockade in pediatric patientsBackground and objective: objective neuromuscular monitoring is evidence-based medical practice and should be routinely used when using neuromuscular blocking drugs. However, research related to this monitoring in pediatric patients is not widely documented as in adults. In clinical research, the neuromuscular monitor should have a stable response (less than 5% change in T1 height) for a period of two to five minutes before administration of the neuromuscular block agent. The time required to achieve this stability in response may vary, but may be shortened by the application of a tetanic stimulus for 5 seconds. It was hypothesized that the application of tetanic stimulus prior to calibration could lead to differences in the parameters of onset of action and recovery times. The primary outcome of this study was to compare time to onset and recovery times after single dose rocuronium 0.6 mg.kg-1 followed by spontaneous recovery between two groups of patients with different sequences for calibration (with and without use of tetanic stimulus). The secondary outcomes were the evaluation of the initial and final T1 height, time to obtain stability of T1 height and the following neuromuscular monitor settings: electric current and sensitivity. Methods: after approval by the Institutional Ethics Committee and obtaining the informed consent of those responsible for the patient, were included in the study 50 patients, physical status 1 or 2, from 2 to 11 years, scheduled for abdominal and/or perineal surgeries with estimated surgical time greater than 60 minutes. Patients (25 per group) underwent intravenous anesthesia and were allocated randomly to receive tetanus stimulation (group T) or not (group C) prior to calibration of the monitor. After calibration of the monitor, train-of-four mode was initiated and maintained at interval of 15 seconds. Results: there was no significant difference in onset of action (C: 57,5±16,9 versus T: 58,3±31,2 s; p=0,917). The train-of-four normalized times 0.7, 0.8 and 0.9 differed significantly between the groups (C: 40,1±7,9 versus T: 34,8±10 min; p=0,047, C: 43,8±9,4 versus T: 37,4±11 min; p=0,045 and C: 49,9±12,2 versus T: 41,7±13,1 min; p=0,026, respectively). The time required to stabilize the T1 height did not show statistical difference between the groups (C: 195±203 versus T: 116±81,6 s; p=0,093), The initial values of T1 height showed a significant difference between the groups (C: 98 versus T: 82,7%; p < 0,001). The final T1 height values also showed a significant difference between the groups (C: 95,3 versus T: 69,3%; p < 0,001). Conclusions: the tetanic stimulus shortened the normalized time of the fourstimulus sequence ratios 0.7, 0.8, and 0.9. The initial and final T1 heights were lower in the tetanus group. There was no statistical difference between the groups regarding the time required to stabilize the T1 height. The monitor settings (electric current and sensitivity) did not show differences between groups. Trial registration: Clinicaltrials.gov identifier: NCT0249867
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Meneses, Clarice Franco. "Segurança da anestesia geral para punção lombar e aspirado/biópsia de medula óssea em pacientes oncológicos pediatricos." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2007. http://hdl.handle.net/10183/12944.
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Introdução: Procedimentos dolorosos de curta duração como o aspirado/biópsia de medula óssea e a punção lombar, com ou sem quimioterapia intratecal, são realizados com freqüência durante o tratamento de crianças com câncer. Estudos examinando diversos métodos de sedação para crianças submetidas aos procedimentos dolorosos têm mostrado diferentes resultados. Enquanto alguns investigadores sugerem que benzodiazepínicos e outras drogas intravenosas são eficazes, outros recomendam anestesia geral breve como sendo superior a todos outros modos de sedação O objetivo desde estudo é descrever a freqüência e a severidade das complicações da AMO/BMO e da PL sob anestesia geral. Pacientes e métodos: Um estudo observacional prospectivo foi realizado de Novembro de 2003 a Agosto de 2005. Pacientes com câncer e idade menor ou igual a 21 anos, em tratamento no Serviço de Oncologia Pediátrica do Hospital de Clínicas de Porto Alegre, submetidos a procedimentos de curta duração, diagnósticos e/ou terapêuticos, sob anestesia geral, no Centro Cirúrgico Ambulatorial. Resultados: Cento e trinta e sete pacientes foram submetidos a 423 procedimentos sob anestesia geral. Eram do sexo masculino 61%, com média de idade de 7,5 anos (0,2 a 21) e ASA II 98%. Oitenta e sete por cento dos procedimentos foram realizados em pacientes com leucemia ou linfoma. A maioria dos procedimentos não determinou eventos adversos durante os períodos intra-operatório e pós-operatório. Nenhum procedimento foi suspenso após iniciado. Um paciente teve dor lombar após o procedimento e foi internado com suspeita de hematoma subdural, o que foi descartado. Nenhum paciente necessitou reanimação cardiopulmonar ou tratamento em unidade de terapia intensiva. CONCLUSÃO: A anestesia geral para procedimentos dolorosos de curta duração, em crianças que realizam tratamento para neoplasias malignas, é segura quando realizada em centro cirúrgico ambulatorial por profissionais treinados.Introduction: Painful short duration procedures like bone marrow aspiration/biopsy and the lumbar puncture with or without intrathecal chemotherapy are frequently performed during the treatment of children with cancer. Studies examining different methods of sedation for children undergoing painful procedures have shown different results. While some investigators suggest that benzodiapines and other intravenous drugs are efficacious, others recommend brief general anesthesia as being superior to all other modes of sedation. The objective of this study is to evaluate the frequency and severity of complications of BMA/BMB and LP under general anesthesia. Patients and methods: Prospective observational study performed from November 2003 to August 2005. Patients with cancer younger than 21 years old, receiving treatment at the Pediatric Oncology Unity of Hospital de Clínicas de Porto Alegre, undergoing diagnostic and/or therapeutic short duration procedures carried out under general anesthesia in the outpatient surgical unit. Results: One hundred and thirty seven patients were submitted to 423 procedures under general anesthesia. There were 61% boys, mean age of 7.5 years (0.2-21) and ASA II 98%. Eighty seven percent of the procedures were carried out in patients with leukemia or lymphoma. The majority of the procedures had no adverse events during intraoperative and postoperative periods. No procedure had to be suspended after it had begun. One patient had lumbar pain after procedure and was admitted to the ward with suspected subdural bleeding, but this was not confirmed. No patient needed cardiopulmonary reanimation or treatment in the intensive care unit. CONCLUSION: General anesthesia for short duration painful procedures in children undergoing treatment for malignancies is safe when carried out by trained professionals in outpatient surgical unit.
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Cabral, Lucas Wynne [UNESP]. "Ultrassonografia para bloqueios periféricos em crianças: revisão sistemática e metanálise de ensaios clínicos randonizados." Universidade Estadual Paulista (UNESP), 2015. http://hdl.handle.net/11449/140218.
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Introdução: acredita-se que a anestesia regional guiada por ultrassonografia (USG) pode melhorar a eficácia dos bloqueios de nervos periféricos e reduzir as complicações na população pediátrica, porém essa hipótese ainda não foi previamente testada de forma quantitativa. Objetivo: a proposta desta revisão sistemática de ensaios clínicos randomizados (ECR) foi avaliar se o uso da ultrassonografia em pediatria melhoraria a taxa de sucesso dos bloqueios e reduziria o índice de complicações comparativamente a outros métodos tradicionais de localização de nervos. Métodos: a pesquisa sistemática, extração dos dados, avaliação crítica e análise conjunta dos dados seguiram as recomendações para a realização de revisões sistemáticas propostas pela Colaboração Cochrane e pela declaração PRISMA. A estratégia de busca incluiu as bases CENTRAL, EMBASE, Medline e Lilacs. A última pesquisa foi realizada em novembro de 2014. O risco relativo (RR) e a diferença média (DM), com seus respectivos intervalos de confiança de 95% (IC 95%), foram calculados utilizando-se o programa estatístico Revman para dados dicotômicos e contínuos, respectivamente. Resultados: onze ensaios clínicos randomizados, publicados entre 2004 e 2013, perfazendo um total de 634 pacientes, cumpriram os critérios de inclusão. A qualidade metodológica foi considerada moderada. Houve um pequeno benefício da ultrassonografia na taxa de sucesso (RR 1,19; IC 95% 1,07-1,32) que foi variável de acordo com a região anatômica avaliada, associado a uma redução na necessidade de analgesia no pós-operatório com o uso da ultrassonografia (RR 0,2; IC 95% 0,11-0,34). Apenas uma complicação foi reportada nos estudos incluídos. Uma punção vascular em um paciente do grupo controle durante realização do bloqueio ílio-inguinal/ílio-hipogástrico (II/IH). Conclusão: existe moderada evidência de que a ultrassonografia quando utilizada para...
Background: it has been suggested that ultrasound-guided regional anesthesia could improve the blockade efficacy and decrease complication rates in the pediatric population, but this hypothesis has not previously been adequately tested in a quantitative manner. Aim: the purpose of this systematic review of randomized clinical trials (RCT) is to assess whether the use of ultrasonography in the pediatric population has advantages over any other method of nerve location, such as the anatomical landmark-based technique, paraesthesia or use of an electrical nerve stimulator. Methods: the systematic search, data extraction, critical appraisal and pooled analysis were performed according to the Cochrane Handbook and PRISMA guidelines. The search strategy included the CENTRAL of the Cochrane Library, Medline, EMBASE, and Lilacs. The date of the last search was November 5, 2014. The relative risk (RR), mean difference (MD) and their corresponding 95% confidence intervals (95% CIs) were calculated using the Revman statistical software for dichotomous and continuous outcomes, respectively. Results: eleven randomized, clinical, controlled trials (published between 2004 and 2013) with a total 634 patients met the inclusion criteria. The methodological quality of the included studies was considered regular. There was a slight benefit of ultrasound to the success rate (RR 1.19, 95% CI 1.07 to 1.33), which was variable according to the anatomical region studied and a more important reduction of the analgesia requirement in the postoperative period with the use of ultrasound for peripheral nerve blocks (RR 0.2, 95% CI 0.11-0.34). There was only one complication reported (blood vessel puncture in one control group). Conclusions: there is moderate evidence that the use of ultrasound-guided peripheral nerve block in children reduces the number of patients requiring additional analgesia in the postoperative period and ...
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Cabral, Lucas Wynne. "Ultrassonografia para bloqueios periféricos em crianças : revisão sistemática e metanálise de ensaios clínicos randonizados /." Botucatu, 2015. http://hdl.handle.net/11449/140218.
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Orientador: Norma Sueli Pinheiro ModoloCoorientador: Regina Paolucci El Dib
Banca: Eliana Marisa Ganem
Banca: Lais Helena Navarro e Lima
Banca: Eneida Maria Vieira
Banca: José Fernando Amaral Meletti
Resumo: Introdução: acredita-se que a anestesia regional guiada por ultrassonografia (USG) pode melhorar a eficácia dos bloqueios de nervos periféricos e reduzir as complicações na população pediátrica, porém essa hipótese ainda não foi previamente testada de forma quantitativa. Objetivo: a proposta desta revisão sistemática de ensaios clínicos randomizados (ECR) foi avaliar se o uso da ultrassonografia em pediatria melhoraria a taxa de sucesso dos bloqueios e reduziria o índice de complicações comparativamente a outros métodos tradicionais de localização de nervos. Métodos: a pesquisa sistemática, extração dos dados, avaliação crítica e análise conjunta dos dados seguiram as recomendações para a realização de revisões sistemáticas propostas pela Colaboração Cochrane e pela declaração PRISMA. A estratégia de busca incluiu as bases CENTRAL, EMBASE, Medline e Lilacs. A última pesquisa foi realizada em novembro de 2014. O risco relativo (RR) e a diferença média (DM), com seus respectivos intervalos de confiança de 95% (IC 95%), foram calculados utilizando-se o programa estatístico Revman para dados dicotômicos e contínuos, respectivamente. Resultados: onze ensaios clínicos randomizados, publicados entre 2004 e 2013, perfazendo um total de 634 pacientes, cumpriram os critérios de inclusão. A qualidade metodológica foi considerada moderada. Houve um pequeno benefício da ultrassonografia na taxa de sucesso (RR 1,19; IC 95% 1,07-1,32) que foi variável de acordo com a região anatômica avaliada, associado a uma redução na necessidade de analgesia no pós-operatório com o uso da ultrassonografia (RR 0,2; IC 95% 0,11-0,34). Apenas uma complicação foi reportada nos estudos incluídos. Uma punção vascular em um paciente do grupo controle durante realização do bloqueio ílio-inguinal/ílio-hipogástrico (II/IH). Conclusão: existe moderada evidência de que a ultrassonografia quando utilizada para...
Abstract: Background: it has been suggested that ultrasound-guided regional anesthesia could improve the blockade efficacy and decrease complication rates in the pediatric population, but this hypothesis has not previously been adequately tested in a quantitative manner. Aim: the purpose of this systematic review of randomized clinical trials (RCT) is to assess whether the use of ultrasonography in the pediatric population has advantages over any other method of nerve location, such as the anatomical landmark-based technique, paraesthesia or use of an electrical nerve stimulator. Methods: the systematic search, data extraction, critical appraisal and pooled analysis were performed according to the Cochrane Handbook and PRISMA guidelines. The search strategy included the CENTRAL of the Cochrane Library, Medline, EMBASE, and Lilacs. The date of the last search was November 5, 2014. The relative risk (RR), mean difference (MD) and their corresponding 95% confidence intervals (95% CIs) were calculated using the Revman statistical software for dichotomous and continuous outcomes, respectively. Results: eleven randomized, clinical, controlled trials (published between 2004 and 2013) with a total 634 patients met the inclusion criteria. The methodological quality of the included studies was considered regular. There was a slight benefit of ultrasound to the success rate (RR 1.19, 95% CI 1.07 to 1.33), which was variable according to the anatomical region studied and a more important reduction of the analgesia requirement in the postoperative period with the use of ultrasound for peripheral nerve blocks (RR 0.2, 95% CI 0.11-0.34). There was only one complication reported (blood vessel puncture in one control group). Conclusions: there is moderate evidence that the use of ultrasound-guided peripheral nerve block in children reduces the number of patients requiring additional analgesia in the postoperative period and ...
Doutor
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College, Courtney R. "Bilateral versus unilateral mandibular nerve block anesthesia in a pediatric population a comparison of the incidence of trauma : a report submitted in partial fulfillment ... for the degree of Master of Science in Pediatric Dentistry ... /." 1997. http://catalog.hathitrust.org/api/volumes/oclc/68802228.html.
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