Postoperative Pain Management in children: guidance from the Pain Committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative) Part II.

The ESPA Pain Management Ladder Initiative is a clinical practice advisory based upon expert consensus supported by the current literature to help ensure a basic standard of perioperative pain management for all children. In 2018 the perioperative pain management of six common pediatric surgical procedures was summarised. The current Pain Management Ladder recommendations focus on five more complex pediatric surgical procedures and suggest basic, intermediate, and advanced pain management methods.

Laser acupuncture treatment of neuropathic pain in a boy with brain tumour.

Neuropathic pain occurrence is associated with some cytostatic and antibiotics use. Pharmacological therapy for the treatment of neuropathic pain is sometimes unsuccessful, and complementary methods like acupuncture are included. In this case report, a 14-year-old boy with cerebral tumour and neuropathic pain in his feet after chemotherapy and linezolid use is presented.

[THE SCALP AS A SPLIT-THICKNESS GRAFT DONOR IN THE TREATMENT OF A MASSIVE THERMAL INJURY].

We are presenting our initial experience with the utilization of the scalp as a donor for split thickness skin grafting in the treatment of massive thermal injuries. Rapid donor reepithelization, absence of hypertrophic scarring in the donor area, inconspicuous donor area and a large area for the procurement of grafts in the pediatric population are the advantages that are emphasized in the literature. The outcome in a 3-year-old boy who suffered a burn injury from an open fire in the family house on the 57% of his total body surface area (48% full thickness burn) showed that the “take rate”, in the absence of a massive local infection, was around 80% and that the scalp can be utilized again as a donor area after a period of 14 days.

[Delirium incidence in pediatric intensive care unit].

Delirium is a serious neuropsychiatric disorder and pediatric delirium (PD) is a similarly serious condition. PD is understudied and very often misdiagnosed, especially in pediatric intensive care units (PICU). It is important to early diagnose PD, so that early psychosocial interventions and therapy can be introduced.

Reversal of thrombocytopenia and bleeding tendency in a preterm neonate with recombinant activated factor VII: case report.

A male neonate, born at 26 weeks of postmenstrual age, with intracranial hemorrhage grade IV and thoracic drainage for artificial tension pneumothorax on day 6 of his life is presented. Despite prior transfusions, the preprocedural hemogram showed marked anemia and thrombocytopenia. To reverse thrombocytopenia and to avoid volume overload, the patient was administered 110 microg kg(-1) of recombinant activated factor VII (rFVIIa) and drainage of the pneumothorax was performed uneventfully.