Lignocaine topicalization of the pediatric airway
Summary The application of topical laryngeal lignocaine is a technique used frequently in pediatric anesthesia. It is often used to facilitate open airway procedures, tracheal intubation, or to reduce the incidence of perioperative adverse respiratory events such as coughing and laryngospasm. A number of studies have shown that applying topical lignocaine to the larynx reduces perioperative respiratory adverse events, while others have shown an increased incidence of respiratory complications with lignocaine administration. There is a lack of evidence on the effect of topical lignocaine on the sensitivity of upper airway reflexes and swallowing, the duration of time that airway reflexes are obtunded, and the optimum and safe maximum dose of lignocaine when used by this route. We review the current literature relating to the use of lignocaine to topicalize the pediatric airway. This review concentrates on the indications for use, the maximum safe dose, the effect on swallowing, and risk of aspiration and the complications of the technique.
Our medical staff just implemented a similar policy. A couple of our surgeons were complaining about it. My group has a mandatory retirement age. EEOC Sues Yale New Haven Hospital for Age and Disability Discrimination
ConclusionsOur neurophysiological study shows that this new 150IDE provides selective information on nociceptive system.
ConclusionPre-peritoneal drainage is clinically safe in laparoscopic totally extra-peritoneal hernioplasty and can effectively reduce the size and incidence of seroma. The seroma formation can be further reduced by appropriate use of monopolar energy as preferred dissection approach in lap TEP. Due to limitation in measuring the actual energy time, the result should be further validated by randomized multi-centers trial on its potential benefit in hernia repair by a more accurate measuring device on energy used.
CONCLUSIONS Sevoflurane-based anesthesia did not increase the incidence of POCD compared to propofol-based anesthesia at 7 days or 3 months post-operation or impact short-term post-operative prognosis. PMID: 32060257 [PubMed - in process]
Conditions: Perioperative Anxiety; Preanesthetic Medication; Inhalation Anesthesia; Ambulatory Surgery; Tonsillectomy; Circumcision; Dental Care Interventions: Drug: Midazolam oral solution; Device: IPAD Sponsor: Universitair Ziekenhuis Brussel Recruiting
Condition: Adverse Effect Interventions: Drug: Norepinephrine; Drug: Normal saline Sponsor: General Hospital of Ningxia Medical University Not yet recruiting
Condition: Decision Making, Shared Intervention: Other: Shared decision making with the used of patient decision aids Sponsors: Taipei Medical University Shuang Ho Hospital; Chi Mei Medical Hospital Not yet recruiting
Condition: General Anesthesia Interventions: Procedure: Pressure controlled ventilation with PEEP; Procedure: Manual ventilation without PEEP Sponsor: Region Västmanland Not yet recruiting
Condition: CO2 Absorbers Intervention: Other: Comparing two CO2 absorbers in the ventilator circuit Sponsor: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) Recruiting
Patient comes in for induction of labor for pre-eclampsia without severe features. They get a CBC on arrival. Platelets are 300. How long is that number valid for you for neuraxial placement? What’s your cut off time for needing a repeat draw? What if pre-E with severe features? There’s no institutional policy at my place, just provider discretion. Just trying to get a feel for what others are doing.