tailieunhanh - Gây mê và giảm đau gãy xương ở trẻ em

Mục đích của gây mê trong việc quản lý ngoại trú của gãy xương ở trẻ em là Để Cung cấp thuốc giảm đau và sự lo lắng Chữa để Tạo thuận lợi cho điều trị thành công các chấn thương xương kín. Nhiều ngắn của các kỹ thuật gây mê toàn thân có sẵn. Phương pháp luận án bao gồm các khối (địa phương, khu vực và tĩnh mạch) an thần | Anesthesia and Analgesia for the Ambulatory Management of Fractures in Children Eric C. McCarty MD Gregory A. Mencio MD and Neil E. Green MD Abstract The goal of anesthesia in the ambulatory management of fractures in children is to provide analgesia and relieve anxiety in order to facilitate successful closed treatment of the skeletal injury. Numerous techniques short of general anesthesia are available. These methods include blocks local regional and intravenous sedation conscious and deep and dissociative anesthesia ketamine sedation . Important factors in choosing a particular technique include ease of administration efficacy safety cost and patient and parent acceptance. Local and regional techniques such as hematoma axillary and intravenous regional blocks are particularly effective for upper-extremity fractures. Sedation with inhalation agents such as nitrous oxide and parenterally administered narcotic-benzodiazepine combinations are not region-specific and are suitable for patients over a wide range of ages. Ketamine sedation is an excellent choice for children less than 10 years old. With any technique proper monitoring and adherence to safety guidelines are essential. J Am Acad Orthop Surg 1999 7 81-91 Fractures in children are common with the majority involving the upper extremities. Most are closed and are best treated by closed reduction. Certainly factors such as time logistics and cost favor treatment in the emergency department or other ambulatory settings as opposed to the operating room. In a study of axillary block anesthesia for the treatment of forearm fractures in the emergency department Cramer et al1 estimated a reduction in cost of almost 70 compared with similar treatment in the operating room. However to be able to perform satisfactory closed treatment of musculoskeletal injuries in an ambulatory setting effective and safe levels of sedation and analgesia are essential to minimize pain and allay the apprehensions of the A variety