Abstract:
BACKGROUND/PURPOSE:Delivery of local anesthesia for surgical office procedures for pediatric patients can be difficult. Injections are painful and often lead to patient anxiety, and topical anesthetics frequently provide incomplete anesthesia. The authors prospectively studied the efficacy of iontophoresis, a needle-free technique in which positively charged lidocaine and epinephrine molecules are drawn into the tissue by an electrical current as an anesthetic for pediatric surgical office procedures. METHODS:Children undergoing an office procedure were offered local anesthesia via iontophoresis. Prospectively collected data included patient characteristics, procedure, iontophoresis dose and time, need for additional injected anesthetic, pain during the procedure as determined by a 0 to 5 faces scale, and complications. A satisfaction questionnaire was completed at the follow-up visit or by telephone. RESULTS:Over an 8-month period, 34 patients with a mean age of 6.8 years (range, 3 months to 15 years) underwent 38 office procedures with anesthesia supplied through iontophoresis. Skin lesion excision (n = 14) and abscess drainage (n = 12) were the most common procedures. Seven patients required unplanned injected anesthetic. A small, superficial burn was the only complication. Sixty percent of patients and 84% of parents rated pain as 0 to 2 (zero to mild). Overall, 88% were satisfied with the anesthetic. CONCLUSION:Iontophoresis appears to be an effective and safe alternative method of local anesthesia delivery for pediatric surgical office procedures.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
DeCou JM,Abrams RS,Hammond JH,Lowder LR,Gauderer MWdoi
10.1016/s0022-3468(99)90765-0subject
Has Abstractpub_date
1999-06-01 00:00:00pages
946-9issue
6eissn
0022-3468issn
1531-5037pii
S0022-3468(99)90765-0journal_volume
34pub_type
杂志文章abstract::Enterocolitis (EC) remains the most serious complication of Hirschsprung's disease (HD). The aetiology of EC is uncertain. Ischemic and bacterial causes, and recently rotavirus infection, have been suggested to explain the occurrence of EC. The gut has an abundance of neuroendocrine (NE) cells which modulate gut funct...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90520-u
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:The Malone antegrade continence enema (MACE) has proved invaluable in the management of children with faecal incontinence. The authors have reviewed their experience in depth to try and ascertain why some MACEs fail. METHODS:The records of 31 children who had a MACE procedure between 1990 and 1995 w...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90381-5
更新日期:1998-01-01 00:00:00
abstract::The gastrointestinal tract harbors several populations of peptide containing nerve fibers. Among the gut neuropeptides are vasoactive intestinal peptide (VIP), substance P, enkephalin, and gastrin releasing peptide (GRP). We have examined specimens from five patients with pyloric stenosis and from five controls immuno...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(86)80189-0
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Pediatric surgery (PS) is among the most competitive fellowship opportunities for general surgery residents. Prior investigations into factors associated with successful matriculation to PS have relied on surveys, which have inherent biases. STUDY DESIGN:Data were extracted from the Electronic Residency App...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.10.057
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:The Nuss procedure corrects pectus excavatum by forceful displacement of the sternum with metal bars. Optimal pain management remains a challenge. Mutimodal anesthesia alleviates pain through blockade of multiple nociceptive and inflammatory pain receptors. METHODS:A retrospective chart review of anesthetic...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.10.084
更新日期:2016-04-01 00:00:00
abstract::Disenchantment with available techniques for specific diagnosis of intrathoracic pulmonary lesions in children has led us to explore the usefulness of thoracoscopy. We have performed this technique in nine patients ranging in age from 17 mo to 16 yr. The procedure is performed under intravenous anesthesia with the pat...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(76)90093-2
更新日期:1976-10-01 00:00:00
abstract::A 5-month-old boy presented with bilateral hydroceles since birth and right leg edema. An ultrasound of the pelvis showed a 4-cm cystic mass that was diagnosed as a teratoma or cystic hygroma. Magnetic resonance imaging was performed, which showed a dumbbell shaped contiguous, fluid filled mass extending intraabdomina...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/0022-3468(92)90295-i
更新日期:1992-10-01 00:00:00
abstract::The need for feeding gastrostomy seems to be increasing in children with neurological impairment and swallowing incoordination. Because gastrostomy can cause or increase gastroesophageal reflux, an antireflux procedure has been advocated at the time of gastrostomy placement in neurologically impaired children. A gastr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90209-r
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND/PURPOSE:Considerable debate surrounds the choice of technique for the removal of esophageal coins: endoscopic extraction versus dislodgement with a Foley balloon versus dislodgement using bougienage. The "penny-pincher" (PP) technique was developed as an alternative, incorporating the main advantages of thes...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(00)90024-1
更新日期:2000-02-01 00:00:00
abstract::There are several reported cases of late presentations of right diaphragmatic hernia with early- as well as late-onset group B streptococcal (GBS) infections. The authors describe the first case of late-onset left diaphragmatic hernia with late onset GBS infection in a preterm infant. The diagnosis was prompted by a d...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.32918
更新日期:2002-06-01 00:00:00
abstract::The prenatal sonographic detection of esophageal atresia (EA) has been possible for more than a decade and relies on the finding of a small or absent fetal stomach bubble associated with maternal polyhydramnios. The aims of this study were to assess the accuracy of this technique and to determine whether the outcome o...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90480-8
更新日期:1995-09-01 00:00:00
abstract:PURPOSE:Keloids occur as a result of abnormal wound healing and as many as 70% of keloids and hypertrophic scars affect the pediatric population. Earlobe keloids, similar to lesions elsewhere in the body, remain a challenging problem given the high rates of recurrence and lack of consensus regarding treatment strategy....
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.07.006
更新日期:2020-03-01 00:00:00
abstract::Pulmonary hydatid disease is prevalent in many parts of world including India. In our small series of 5 pediatric patients, all patients were diagnosed with clinical and radiological findings on plain X-ray chest and CT (Computed Tomography) chest. All of them received oral albendazole 10 mg/kg/day soon after diagnosi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.11.029
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Rhabdoid tumors (RTs) of the liver are rare, aggressive and nonsecreting malignancies occurring mainly during the first year of life. Definition of RT relies on characteristic morphology and on the inactivation of the SMARCB1 tumor suppressor gene. The aim of this study was to analyze clinical data, treatmen...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.09.005
更新日期:2018-03-01 00:00:00
abstract:PURPOSE:Patients with intestinal failure (IF) are known to have impaired absorption of nutrients required for maintenance of skeletal mass. Rates and risk factors of low bone mineral density (BMD) are unknown in pediatric IF patients. METHODS:Following IRB approval, patients with IF having undergone DXA scans were ide...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.10.010
更新日期:2015-01-01 00:00:00
abstract::The authors report the rare case of a dipygus monster. The infant had an omphalocele, a secondary pelvis with two limbs, an accessory pelvic kidney, and two bladders. At operation, the secondary pelvis and extremities were removed, and the omphalocele was repaired. The postoperative course was complicated by wound inf...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(79)80140-2
更新日期:1979-10-01 00:00:00
abstract:PURPOSE:The purpose of the study was to compare outcomes of pediatric patients with high-risk metastatic neuroblastoma who received radiotherapy (RT) with those of patients who did not. PATIENTS AND METHODS:We reviewed the records of 63 patients with newly diagnosed metastatic neuroblastoma treated at our institution ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.11.003
更新日期:2010-04-01 00:00:00
abstract::The lungs of patients born with severe congenital diaphragmatic hernia (CDH) are biochemically and morphologically immature. Because antenatal glucocorticoid therapy can accelerate pulmonary maturation in premature neonates who have respiratory distress syndrome, we hypothesized that it may correct the pulmonary bioch...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90348-4
更新日期:1994-02-01 00:00:00
abstract::Every year in the United States, 1.6 to 3.8 million concussions occur secondary to injuries sustained during sports and recreational activities. Major advances have been made in terms of identifying specific clinical profiles following concussion. Nevertheless, there are continued misunderstandings regarding this inju...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.10.011
更新日期:2017-01-01 00:00:00
abstract::Sirenomelia, or the mermaid syndrome, is the most extreme example of the caudal regression syndrome. It invariably presents with lower limb fusion, sacral and pelvic bony anomalies, absent external genitalia, anal imperforation, and renal agenesis or dysgenesis. Because of the resultant oligohydramnios, these infants ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)90614-y
更新日期:1991-11-01 00:00:00
abstract::Anaplastic infiltrative adenocarcinoma of the linitis plastica morphologic type is rare in children. The case of a 15-year-old child with this unusual form of gastric carcinoma is presented. One year postoperatively following radiation and chemotherapy, the child is free of disease. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(85)80401-2
更新日期:1985-02-01 00:00:00
abstract:BACKGROUND/PURPOSE:Intrathyroidal thymic tissue may be misinterpreted as a thyroid lesion in children, leading to invasive tests or resection. We sought to describe the characteristic imaging features of these lesions and to evaluate the safety of non-operative management. METHODS:A retrospective review of all patient...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.02.011
更新日期:2018-05-01 00:00:00
abstract::In order to examine surgical factors predictive of fatal outcome in patients presenting with histologically verified rhabdomyosarcoma of the urinary bladder, we performed a retrospective analysis of cases presenting between the years 1970 and 1985 and treated by protocol. Twenty-five patients were identified and data ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90220-4
更新日期:1990-10-01 00:00:00
abstract::We modified conventional hepatic portoenterostomy by pulling the remnant fibrous mass caudally and placing 5 or 6 numbered and individually clamped absorbable 5-0 double-needle sutures horizontally in the liver surface of the posterior side of the remnant fibrous mass before excision and apposing the posterior and ant...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.12.056
更新日期:2006-05-01 00:00:00
abstract::A mass spectrometer blood gas catheter system for the continuous in vivo analysis of Po2 and Pco2 has been presented. This system has been experimentally evaluated and demonstrated to be reliable and reproducible over a period of 30 hr following insertion of the catheter in the abdominal aorta. Although the present ca...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(76)80078-4
更新日期:1976-12-01 00:00:00
abstract:PURPOSE:To determine whether treatment of lichen sclerosus et atrophicus (LS), with topical steroids reduces the rate of circumcision. METHODS:Two independent reviewers performed a literature search of studies reporting treatment of LS with topical steroids using EMBASE and MEDLINE database(s). INCLUSION CRITERIA:boy...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.12.021
更新日期:2018-11-01 00:00:00
abstract::A 10-month-old boy was noted to have hepatomegaly, and hepatic angiography showed a huge tumor of the medial segment of the left lobe, located close to the hepatic hilum and involving the anterior segment of the right lobe in contiguity. We considered at first that resection would not be possible, but at operation the...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80109-5
更新日期:1989-11-01 00:00:00
abstract:PURPOSE:Small bowel transplantation (SBT) is the ultimate treatment for intestinal failure. It remains unclear as to which intestinal segment is more suitable for use in segmental SBT. The current study aims to assess the susceptibility of various parts of small intestine to ischemia and reperfusion injury and their ca...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90614-5
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:The likelihood of a lead point as the cause of ileocolic intussusception increases as children get older. This study looks at whether a different management strategy should be employed in older patients. METHODS:7 year multi-institutional retrospective study of intussusception in patients aged <12 years. R...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2014.09.078
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Robotic surgery is a new technology that may eventually replace laparoscopy in treating many surgical issues in children. Resident education using robotic surgery has been a concern for many institutions. We present our first 50 consecutive robotic fundoplications in children and our teaching experience with...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.08.022
更新日期:2007-12-01 00:00:00