Epidural analgesia in children: planning, organization and development of a new program.

Abstract:

BACKGROUND:The goal of the present work is to describe the development and results of the pediatric epidural analgesia program at the ''Hospital Nacional de Pediatria Prof. Dr. J. P. Garrahan'' in Argentina. METHODS:Patients with thoracotomy, abdominal surgery, osteotomy, amputations or severe trauma were included in the program. The program provided training to the entire staff, control and record of pain treatment and its consequences, 24 h a day availability of anesthesia staff and standard polices and procedures. RESULTS:One hundred fifty children under 16 years of age (median age 11 years, median weight 35 kg) were included in the program during the first 18 months. The median of maximum pain reported during activity was 1 (interquartile range 1 to 4 points) using the Visual Analogue Scale (VAS) or Objective Pain Scale (OPS). Eighty seven children (CI 95% 50% to 67%) presented with postoperative nausea and vomiting, urinary retention, itching, motor blockade or sedation. No patient presented with respiratory depression, hypotension, local anaesthetic toxicity, epidural catheter related infection or death during the program evaluation. The postoperative care program enabled a 98-day reduction in treatment in the intensive care unit. CONCLUSION:The safe use of pediatric epidural analgesia in general wards may require the careful selection of patients, systematic assessment by trained personnel, training of medical and nursing personnel, clear distribution of responsibilities, use of printed indications, systematic record of pain, sedation and complications, information and education of patients and parents, supply of systems for airway resuscitation and management and continuous quality control and revision of the methods.

journal_name

Minerva Anestesiol

journal_title

Minerva anestesiologica

authors

Ingelmo PM,Gelsumino C,Acosta AP,Lopez V,Gimenez C,Halac A,Lira P,Schon A,Spagnolo B,Pignataro A,Nunez G,Gamboa M,Buquicchio I,Astuto M,Fumagalli R

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

575-85

issue

11

eissn

0375-9393

issn

1827-1596

journal_volume

73

pub_type

杂志文章
  • Thoracic epidural anesthesia decreases C-reactive protein levels in patients undergoing elective coronary artery bypass graft surgery with cardiopulmonary bypass.

    abstract:BACKGROUND:Coronary artery bypass graft surgery with cardiopulmonary bypass induces a systemic inflammatory response. However, when thoracic epidural anaesthesia is administered as part of a combined anesthetic technique, the stress response associated with the cardiopulmonary bypass (CPB) may be attenuated. METHODS:T...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Palomero Rodríguez MA,Suarez Gonzalo L,Villar Alvarez F,Varela Crespo C,Moreno Gomez Limon I,Criado Jimenez A

    更新日期:2008-11-01 00:00:00

  • [Intravenous anesthesia with perfused propofol combined with loco-regional spinal anesthesia].

    abstract::The authors review the advantages and disadvantages of general and regional anesthesia in bad clinical conditions. The purpose of this study was to evaluate the efficacy of Blended Anesthesia (association of general anesthesia with a regional technique) in 25 patients belonging to ASA classes II-III-IV, undergoing sur...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Lo Presti C,Vitalone V,Fusco G,Assisi P

    更新日期:1993-04-01 00:00:00

  • [Pharmacologic prevention of Mendelson syndrome. A controlled clinical trial].

    abstract::This controlled study considers the effect of ranitidine, both alone and in association with metoclopramide, on the acidity and volume of the gastric content of 75 patients requiring caesarean section. Ranitidine, when used alone (50 mg intravenously 30-60 minutes before the operation) significantly reduced (p less th...

    journal_title:Minerva anestesiologica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Bifarini G,Favetta P,Ciammiti B,Cirulli P,Del Sindaco F,Pasqualucci A

    更新日期:1992-03-01 00:00:00

  • Long-term extracorporeal membrane oxygenation with minimal ventilatory support: a new paradigm for severe ARDS?

    abstract::Pulmonary tuberculosis can lead to acute respiratory distress syndrome (ARDS) which is associated with high mortality. We report the case of a patient with pulmonary tuberculosis and severe ARDS (PaO2/FiO2<100 mmHg) who was initially managed with advanced up-to-date treatments (protective ventilation and extracorporea...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Mauri T,Foti G,Zanella A,Bombino M,Confalonieri A,Patroniti N,Bellani G,Pesenti A

    更新日期:2012-03-01 00:00:00

  • [Non-invasive positive pressure mechanical ventilation in acute respiratory failure].

    abstract::Known for two centuries, positive pressure non invasive mechanical ventilation (VMNPP) has been widely applied in acute respiratory failure (IRA) only in the last ten years. The fact that VMNPP is able to improve gas exchange by avoiding endotracheal intubation and its complications is the most attractive aspect in bo...

    journal_title:Minerva anestesiologica

    pub_type: 历史文章,杂志文章,评审

    doi:

    authors: Scala R

    更新日期:2000-10-01 00:00:00

  • [The laryngeal mask in pediatric anesthesia].

    abstract::AIM. To evaluate the validity of general anesthesia using the laryngeal mask airway (LMA) in pediatrics in a series of 163 patients. MONITORING. ETCO2 and SpO2 were evaluated five minutes after the insertion of LMA and then at five minute intervals. SpO2 was evaluated every two minutes after the removal of LMA. Use of...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Piana R,Bruno G,Meo MT,Tamanti P,Zuccaro G

    更新日期:1996-01-01 00:00:00

  • [Report of a case of spontaneous thrombolysis].

    abstract::Spontaneous thrombolysis is a quite rare event. It's not predictable through a clinical examination of the patient, but there are some markers that are supposed to be diagnostic because of the high percentage of their occurrence in coincidence with spontaneous thrombolysis. The goal of the authors is to describe a cas...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Mennini MS,D'Aiutolo V,Cerroni A

    更新日期:1993-09-01 00:00:00

  • [The use of low doses of intermediate acting muscle relaxants in adenotonsillectomy].

    abstract::In this study we compared the efficacy of a reduced dose of medium term neuromuscular blocking agents atracurium (0.20 mg/kg) and vecuronium (0.04 mg/kg) in short-term (8-10 min) pediatric surgery. Eighty-four children (ASA I and II) undergoing adenotonsillectomy were selected for this study. Their average age was 56 ...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Frediani M,Capanna M,Casini L,Lorenzetti MG,Bianchini G,Pacini P

    更新日期:1993-03-01 00:00:00

  • [Hormonal and metabolic response to trauma: physiopathology and therapeutic management].

    abstract::This article is a review of present knowledge of the hormonal and metabolic responses to trauma and surgery. The factors which may mediate the responses are discussed and the potential value of different therapeutic manipulations are reviewed. The accelerated breakdown of muscle following significant injury is the mos...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Ronzoni G,Carli F

    更新日期:1992-06-01 00:00:00

  • [Effects of extracorporeal circulation and hypothermia on cellular immune activity in patients undergoing heart surgery].

    abstract::Aspecific cellular reactivity was assessed in patients who underwent open heart surgery. The authors conclude that depressed PMN activity measured as O2- production is not linked to anaesthesiological procedures, hemodilution and hypothermia. No conclusive reports are possible on the role of pulmonary reinfusion or pl...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Pasetto A,Gilli E,Rigotti L,Girardi G,Bartoloni A,Ischia A

    更新日期:1989-07-01 00:00:00

  • Anaesthetic management in asthma.

    abstract::Anaesthetic management in asthmatic patients has been focused on avoiding bronchoconstriction and inducing bronchodilation. However, the definition of asthma has changed over the past decade. Asthma has been defined as a clinical syndrome characterized by an inflammatory process that extends beyond the central airways...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Burburan SM,Xisto DG,Rocco PR

    更新日期:2007-06-01 00:00:00

  • Effect of morbid obesity on kinetic of desflurane: wash-in wash-out curves and recovery times.

    abstract:AIM:The aim of this paper was to compare wash-in and wash-out curves of desflurane in morbidly obese and nonobese patients. METHODS:Fourteen patients (7 obese and 7 nonobese) were studied. In the nonobese patients, anaesthesia was started by administering 2 mg/kg propofol bolus and a target controlled effect site conc...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: La Colla G,La Colla L,Turi S,Poli D,Albertin A,Pasculli N,Bergonzi PC,Gonfalini M,Ruggieri F

    更新日期:2007-05-01 00:00:00

  • [Continuous intravenous infusion with patient-controlled anesthesia for postoperative analgesia in cesarean section: morphine versus buprenorphine].

    abstract::A double blind comparison between morphine and buprenorphine was performed in 20 patients using a new demand and continuous infusion analgesic system to provide analgesia after cesarean section. The patients were randomized in two equal groups to receive either morphine 1 mg/h or buprenorphine 0.03 mg/h. The PCA syste...

    journal_title:Minerva anestesiologica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Capogna G,Celleno D,Sebastiani M,Costantino P,Reggio S

    更新日期:1989-01-01 00:00:00

  • Incidence of anaerobic bacteria in patients with suspected pneumonia in surgical Intensive Care Unit.

    abstract:BACKGROUND:Few studies have investigated the incidence of pulmonary anaerobes in a specific population in surgical Intensive Care Unit (ICU). The objective of this work was to determine the incidence of anaerobes in surgical ICU patients with suspected pneumonia. METHODS:This was a prospective observational, single-ce...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Clavier T,Gouin P,Frebourg N,Rey N,Royon V,Bergis A,Hobeika S,Dureuil B,Veber B

    更新日期:2014-10-01 00:00:00

  • [Evaluation of cerebral perfusion during aortic clamping and cross-clamping in patients undergoing resection for abdominal aortic aneurysm. A study with transcranial doppler].

    abstract:OBJECTIVE:To evaluate the cerebral blood flow parameters assessed by transcranial Doppler during aortic cross-clamping and unclamping in patients undergoing abdominal aortic aneurysmectomy. METHODS:Invasive intraoperative monitoring of mean arterial pressure (MAP) and PaCO2, and right middle cerebral artery (RMCA) mon...

    journal_title:Minerva anestesiologica

    pub_type: 临床试验,杂志文章

    doi:

    authors: Pittella G,Benanti CF,Palombo C,Kozàkovà M,Distante A,Giunta F

    更新日期:1997-03-01 00:00:00

  • Acute reduction of cerebrospinal fluid volume prior to spinal anesthesia: implications for sensory block extent.

    abstract:BACKGROUND:Multiple patient and clinical characteristics contribute to the variable outcome of spinal anesthesia (SPA). Acute reduction of cerebrospinal fluid (CSF) volume may alter the effect of SPA. The objective of the present study was to test if aspiration of 10 mL CSF immediately prior to SPA is associated with h...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:10.23736/S0375-9393.20.14138-5

    authors: Bjurström MF,Mattsson N,Harsten A,Dietz N,Bodelsson M

    更新日期:2020-06-01 00:00:00

  • Failure of an Abiomed left ventricular assist device in association with factor VIIa administration.

    abstract::Factor VIIa might be a useful treatment for coagulopathy and massive hemorrhage following implantation of a mechanical circulatory assist device, but there is a theoretical risk of device thrombosis. To date this complication has not been reported. We describe the first case of clotting of a left ventricular assist de...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Reade MC,Toyoda YN,Murray HN

    更新日期:2008-04-01 00:00:00

  • [Levobupivacaine in obstetric analgesia and anaesthesia].

    abstract:METHODS:Published studies, including abstracts, has been reviewed and summarized. RESULTS:Studies in sheep have demonstrated no significant differences in pharmacokinetic and placental transfer of levobuvacaine when compared with bupivacaine. Clinical studies on cesarean section confirmed similar performance between t...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Capogna G,Celleno D,Camorcia M

    更新日期:2001-09-01 00:00:00

  • Diagnosis and therapy of intrathecal bleeding.

    abstract:AIM:Define pathophysiology, epidemiology, diagnosis and therapy in case of spinal bleeding after central neural blockade (CNB). METHODS:Spinal epidural hematoma (SEH) following CNB may occur due to vascular trauma from needle/catheter placement and can occur in subdural and epidural spaces. Epidural artery bleeding se...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Nolli M,Crispino M,Nicosia F,Borghi B,Montone N

    更新日期:2001-09-01 00:00:00

  • Time to wake up the patients in the ICU: a crazy idea or common sense?

    abstract::With the first generation of ventilators, it was often necessary to sedate patients to avoid dyssynchrony between patient and ventilator. The standard treatment of patients in need of mechanical ventilation has therefore traditionally included sedation. Modern ventilators are able to simulate the patients breathing ef...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Strøm T,Toft P

    更新日期:2011-01-01 00:00:00

  • [Validity of computer simulation in closed circuit anesthesia].

    abstract::Developing a computer program to simulate the uptake, distribution, and elimination of inhalational anesthetics allow the anesthesiologist to address specific problems, but intense skills are required to translate the involved process first into a set of mathematical equations and then into a satisfactory computer pro...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Maione M,Fabbrini GP,Grassi P,Mazzi C,Farnesi C

    更新日期:1993-01-01 00:00:00

  • Inhaled nitric oxide during anesthesia for bilateral single lung transplantation. Case report.

    abstract::Recently inhaled nitric oxide (iNO) has been used as pulmonary vasodilator without any effect on systemic hemodynamics. iNO has been also used in cardiac and thoracic surgery, involving lung transplantation. In this case report a patient, 41 years old female, affected by bronchiectasis, underwent bilateral sequential ...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Della Rocca G,Pugliese F,Antonini M,Coccia C,Pompei L,Venuta F,Rendina EA,Ricci C

    更新日期:1998-06-01 00:00:00

  • Response to ASA and ESA fasting guidelines are not in concert.

    abstract:: ...

    journal_title:Minerva anestesiologica

    pub_type: 评论,信件

    doi:10.23736/S0375-9393.19.13630-9

    authors: Presta MV,Bhavani SS,Abdelmalak BB

    更新日期:2019-07-01 00:00:00

  • Metabolic stress during hypoglycaemia clamp assessed by microdialysis.

    abstract:AIM:Microdialysis allows the biochemical analysis of interstitial fluids as a bedside procedure. This technique is of interest to evaluate the glucose dependent metabolism in hypoglycaemic patients. It was the aim to perform subcutaneous and blood microdialysis during hypoglycaemic clamp experiments in 12 healthy young...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Bahlmann L,Oltmanns KM,Peters A,Poeling J,Schwemmer U,Heringlake M,Klaus S

    更新日期:2005-11-01 00:00:00

  • Influence of LMA cuff pressure on the incidence of pharyngolaryngeal adverse effects and evaluation of the use of manometry during different ventilation modes: a randomized clinical trial.

    abstract:BACKGROUND:Pharyngolaryngeal discomfort is a significant complication following the use of laryngeal mask airway (LMA). The present study aimed to investigate the relation of LMA cuff pressure and the occurrence of pharyngolaryngeal discomfort during spontaneous ventilation (SV), pressure support (PSV) and pressure con...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Chantzara G,Stroumpoulis K,Alexandrou N,Kokkinos L,Iacovidou N,Xanthos T

    更新日期:2014-05-01 00:00:00

  • Postoperative pain treatment SIAARTI Recommendations 2010. Short version.

    abstract::The aim of these recommendations is the revision of data published in 2002 in the "SIAARTI Recommendations for acute postoperative pain treatment". In this version, the SIAARTI Study Group for acute and chronic pain decided to grade evidence based on the "modified Delphi" method with 5 levels of recommendation strengt...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,实务指引

    doi:

    authors: Savoia G,Alampi D,Amantea B,Ambrosio F,Arcioni R,Berti M,Bettelli G,Bertini L,Bosco M,Casati A,Castelletti I,Carassiti M,Coluzzi F,Costantini A,Danelli G,Evangelista M,Finco G,Gatti A,Gravino E,Launo C,Loreto M,

    更新日期:2010-08-01 00:00:00

  • [Surgical indications for the treatment of cervico-spinal cord injuries].

    abstract::The surgical treatment of cervico-medullary traumas is indicated, in unstable lesions, in large lesions of the mobile rachidic segment in the presence of neurological complications or following worsening of prior neurological symptomatology. The purpose of the operation is at least three-fold: to obtain alignment of v...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Fasano VA

    更新日期:1989-03-01 00:00:00

  • [Case report: application of peridural stimulation in a case of intractable coccygodynia].

    abstract::The Authors report a case of coccygodynia following a car accident and describe the therapeutic approach used. In view of the clinical characteristics of pain and the limited quality and duration of benefits, it was proposed to insert an epidural neurostimulation electrode in an attempt to normalise the threshold of n...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Poggi A,Fanchini P,Fara B

    更新日期:1992-11-01 00:00:00

  • Levobupivacaine plus fentanyl versus racemic bupivacaine plus fentanyl in epidural anaesthesia for lower limb surgery.

    abstract:BACKGROUND:To compare the anaesthetic epidural effects of levobupivacaine plus fentanyl versus bupivacaine plus fentanyl in patients undergoing lower limb surgery. METHODS:A single blind, randomised, prospective, multicentre study was designed to compare both therapies. The study was conducted in 10 tertiary hospitals...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:

    authors: Casimiro C,Rodrigo J,Mendiola MA,Rey F,Barrios A,Gilsanz F

    更新日期:2008-07-01 00:00:00

  • [The effect of various drugs on post-operative pain-producing sensations].

    abstract::The influence of diazepam, the hemisuccinic ester of oxazepam, fentanyl and pentazocine on pain-producing sensation after surgery was tested in 160 patients subjected to ordinary and major surgery. Use was made of Dundee and Moore's modification of Clutton-Brock's test, and Bromage's test. Analysis of the results indi...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Gerardi AU,Miletti S,Miele G

    更新日期:1980-05-01 00:00:00