Background Uncuffed endotracheal tubes are routinely used in young children. This study tests a formula for selecting appropriately sized cuffed and compares the use of versus uncuffed patients whose lungs mechanically ventilated during anesthesia. Methods Full-term newborns children (n = 488) through 8 yr age who required general anesthesia tracheal intubation were assigned randomly to receive either tube by new [size(mm internal diameter) (age/4) + 3], or an modified Cole's 4]. The number...

Midazolam is widely used as a preanesthetic medication for children. Prior studies have extemporaneous formulations to disguise the bitter taste of IV midazolam and improve patient acceptance, but with unknown bioavailability. In this prospective, randomized, double-blinded study we examined efficacy, safety, acceptability three doses (0.25, 0.5, 1.0 mg/kg, up maximum 20 mg) commercially prepared Versed® syrup (midazolam HCl) in children stratified by age (6 mo <2 yr, 2 <6 6 <16 yr). All...

Inherited erythromelalgia/erythermalgia (IEM) is a neuropathy characterized by pain and redness of the extremities that triggered warmth. IEM has been associated with missense mutations voltage-gated sodium channel Na v 1.7, which preferentially expressed in most nociceptive dorsal root ganglia (DRGs) sympathetic ganglion neurons. Several occur cytoplasmic linkers only two segment 4 (S4) S6 domain I. We report here simplex case an alanine 863 substitution proline (A863P) S5 II 1.7. The...

In Brief BACKGROUND: This is an audit of the continuous peripheral nerve blockade (CPNB) program that was implemented at our institution to provide postoperative analgesia after orthopedic procedures in children. METHODS: We reviewed departmental regional anesthesia registry and medical records consecutive children who received CPNB for The Children's Hospital Philadelphia between February 2003 July 2006. Patients were prospectively followed until cessation effects and/or resolution any...

Children learn to cope with pain within the context of family and parental responses pediatric can impact health outcomes. The aim this study was examine relationships among pain, protective functional disability, catastrophizing for adolescents chronic musculoskeletal syndromes.Initial evaluation records 138 who consulted a multidisciplinary management clinic were examined. Measures collected at time initial included adolescent self-reports their own usual intensity, perceived...

We compared the effects of oral clonidine (4 μg/kg) and midazolam (0.5 mg/kg) on preanesthetic sedation postoperative recovery profile in children during tonsillectomy with or without adenoidectomy. In a double-blinded, double-dummy study design, 134 ASA physical status I-II aged 4–12 yr were randomized to receive combination either placebo (Group A), B) at 60–90 min 30 min, respectively, before induction anesthesia. Children group exhibited more intense anxiety separation anesthesia via...

To explore relationships between beliefs and worries held by parents of adolescents with chronic, nondisease specific, musculoskeletal pain (1) parental promoting behaviors, (2) the adolescent's pain-related disability, (3) family functioning, (4) parenting stress.A retrospective chart review was conducted for 138 chronic syndromes presenting at an outpatient pediatric multidisciplinary management clinic. Adolescents reported on pain, behaviors. Parents their about cause responsibility worry...

Midazolam is widely used as a preanesthetic medication for children. Prior studies have extemporaneous formulations to disguise the bitter taste of IV midazolam and improve patient acceptance, but with unknown bioavailability. In this prospective, randomized, double-blinded study we examined efficacy, safety, acceptability three doses (0.25, 0.5, 1.0 mg/kg, up maximum 20 mg) commercially prepared Versed® syrup (midazolam HCl) in children stratified by age (6 mo <2 yr, 2 <6 6 <16 yr). All...

This prospective, randomized, placebo-controlled, double-blinded study evaluated the antiemetic efficacy of ondansetron and metoclopramide in 90 ASA physical status I or II children, 2-17 yr age, undergoing strabismus repair. After anesthetic induction prior to eye muscle manipulation, subjects received normal saline 0.3 mL/kg (Group 1), 0.25 mg/kg 2), 0.15 3), intravenously. There were no differences between groups with respect weight, gender, fluids received, number muscles repaired,...

The aim of this study was to explore gender differences in anticipatory emotional distress, coping strategies, post-operative pain perception, and patient-controlled analgesia (PCA) use among adolescent surgical patients. One hundred two 12–18-year-old adolescents undergoing surgeries with overnight hospital stay were recruited. Participants completed pre-operative measures anxiety anticipated pain. Post-operatively, they reported on skills, anxiety, Data PCA recorded from medical records....

Erythromelalgia is a rare, chronic, debilitating condition characterized by redness, warmth, and severe burning pain of the distal extremities. The feet are more commonly affected than hands. Pain precipitated increases in temperature exercise. Patients often obtain relief immersing extremity cold water. refractory to treatment. For many patients, multiple medications have been useless achieving complete symptoms. Previous reports erythromelalgia among adolescents indicated prolonged with...

Opioid-induced respiratory depression (OIRD) is a life-threatening complication of opioid therapy in children. Naloxone administration triggered by OIRD has been used to monitor safety adults. We this trigger as quality measure hospitalized children identify risk predictors OIRD.We retrospectively reviewed medical records 38 patients identified from the hospital management database requiring naloxone for critical events between January 2010 and June 2012 demographics, comorbidities, surgery,...

Pain during venipuncture is a major source of concern to children and their caretakers. Iontophoresis novel technique that uses an electrical current facilitate movement solute ions (lidocaine) across the stratum corneum barrier provide dermal analgesia. In this study, we compared analgesia provided by lidocaine iontophoresis eutectic mixture local anesthetics (EMLA®). After informed consent, 26 children, aged 7–16 yr, who required venous cannulation on multiple occasions, were enrolled in...

In this double-blinded, randomized, multicenter study, we examined analgesic efficacy and tolerability of tramadol in postoperative pediatric patients. Eighty-one postsurgical ASA physical status I II patients ages 7–16 yr received oral (approximately 1 or 2 mg/kg) for analgesia when they were ready to transition from morphine patient-controlled analgesics. Rescue consisted an equivalent dose oxycodone. Patients rated their pain just before the administration at regular intervals 8 h...

Pediatric Pain Management and Sedation Handbook., M. Yaster. St. Louis, MO: Mosby-Year Book, 1997. ISBN 0-8151-9516-8. 600 pp., $36.95. The Handbook is a paperback reference book intended for broad audience, i.e., all clinicians responsible the management of painful conditions or sedation procedures in children. editors' objective was to consolidate vast knowledge acquired over last decade on subject present it concise, practical, portable format. editors are recognized experts this field...

The administration of epidural opioids, though effective for producing analgesia, has severe side effects in most patients. It is unknown whether clonidine can effectively replace opioids and cause fewer effects. We compared, this randomized trial, the incidence vomiting pruritus as well analgesic profile three different combinations bupivacaine, fentanyl, administered epidurally patients undergoing Nuss procedure: bupivacaine + clonidine, fentanyl clonidine. was significantly less group...

OBJECTIVE. The Comparison of Venipuncture and Venous Cannulation Pain After Fast-Onset Needle-Free Powder Lidocaine or Placebo Treatment trial was a randomized, single-dose, double-blind, phase 3 study investigating whether needle-free powder lidocaine delivery system (a sterile, prefilled, disposable that delivers into the epidermis) produces effective local analgesia within 1 to minutes for venipuncture peripheral venous cannulation procedures in children. METHODS. Pediatric patients (3–18...