The effect of continuous wound infusion of ropivacaine on postoperative pain after median sternotomy and mediastinal drain in children.

Background: Postoperative pain after median sternotomy is usually treated with i.v. opioids.

Acetaminophen improves analgesia but does not reduce opioid requirement after major spine surgery in children and adolescents.

Study Design: A randomized, placebo-controlled, double-blind study to evaluate the effect of intravenously (IV) administered acetaminophen on postoperative pain in children and adolescents undergoing surgery for idiopathic scoliosis or spondylolisthesis.

Objective: To evaluate effectiveness of IV-administered acetaminophen on postoperative analgesia, opioid consumption, and acetaminophen concentrations after major spine surgery in adolescents.

Summary Of Background Data: Scoliosis surgery is associated with severe postoperative pain, most commonly treated with IV-administered opioids.

Spectral entropy as a measure of hypnosis and hypnotic drug effect of total intravenous anesthesia in children during slow induction and maintenance.

Background: We evaluated whether spectral entropy (SpE) can measure the depth of hypnosis and the hypnotic drug effect in children during total intravenous anesthesia.

Methods: Sixty healthy children, aged 3-16 yr, were studied. Anesthesia was induced with an increasing target controlled infusion of propofol, and maintained by a stable remifentanil infusion and variable concentrations of target controlled infusion propofol.

The Narcotrend index indicates age-related changes during propofol induction in children.

Background: The Narcotrend electroencephalogram monitor is designed to measure hypnotic state during anesthesia. We performed this study to evaluate the effectiveness and reliability of the Narcotrend monitor in assessing hypnotic state and loss of consciousness (LOC) during propofol anesthesia induction in children.

Methods: Sixty-two children, aged 1-5 (n = 17), 6-12 (n = 23), and 13-16 (n = 21) yr, scheduled for elective surgery were studied.

Horner's syndrome secondary to internal jugular venous cannulation.

Horner's syndrome is a rare complication following insertion of a central catheter into the internal jugular vein (IJV). A 5-year-old boy, who developed unilateral Horner's syndrome postoperatively following IJV cannulation, is presented. The Horner's syndrome resolved completely after 5 months.

Optimally fitted tracheal tubes decrease the probability of postextubation adverse events in children undergoing general anesthesia.

Background: The air leak test is recommended for assessing the appropriate size of an uncuffed tracheal tube (TT) in children. Our objectives were to determine whether there is a certain threshold air leak value beyond which a higher risk for adverse events after removal of TT can be predicted and to define other risk factors related to extubation.

Methods: We enrolled 234 cases ranging from newborn to 9 years of age requiring tracheal intubation for elective or emergency surgery.

The analgesic efficacy of acetaminophen, ketoprofen, or their combination for pediatric surgical patients having soft tissue or orthopedic procedures.

The combined use of acetaminophen and a nonsteroidal antiinflammatory drug has been shown to provide better postoperative analgesia than either drug alone in several adult studies. However, there are no pediatric studies analyzing similar effects when the currently recommended doses of acetaminophen are used. In a double-blind, placebo-controlled design we randomized 120 children, aged 1-9 yr, undergoing orthopedic or soft tissue surgery, into 3 groups to receive either acetaminophen 60 mg/kg rectally and 40 mg/kg orally, ketoprofen 2 mg/kg IV twice, or the combination of the active drugs.

Spectral entropy as a measure of hypnosis in children.

Background: The Datex-Ohmeda S/5 Entropy Module (Datex-Ohmeda Division, Instrumentarium Corp., Helsinki, Finland), using time-frequency balanced Spectral Entropy, is a novel tool for monitoring the hypnotic state during anesthesia. The Entropy Module produces two values, State Entropy (SE) and Response Entropy (RE), and in adults, it has been shown to measure reliably the hypnotic effects of various drugs.