@article {10441, title = {Impact of near infrared light in pediatric blood drawing Centre on rate of first attempt success and time of procedure.}, journal = {Ital J Pediatr}, volume = {44}, year = {2018}, month = {2018 May 25}, pages = {60}, abstract = {

BACKGROUND: Peripheral blood access and venipuncture are a stressful and painful experience in pediatric patients; moreover, it is estimated that more than one attempt is required to achieve the procedure in about one third of children. For this reason, we investigated if Near-infrared light technology routinely used, could give an advantage to venipuncture in a pediatric blood center setting.

METHODS: We conducted an open, pseudo-randomized controlled trial with two parallel arms, in the blood-drawing center, with enrolment of 115 patients between 0 and 18~years, in 14 consecutive working days. Fifty-three subjects were enrolled in group 1 (VeinViewer{\textregistered}) and 62 in group 2 (control group). We divided patients into three subgroups considering their age (< 5~years, 6-10~years, > 10~years). The primary study outcome was to assess if the use of VeinViewer{\textregistered} was associated with a reduction of time to perform blood sampling. The secondary outcome was to analyze VienViewer{\textregistered}{\textquoteright}s impact on first attempt success rate in blood sampling.

RESULTS: No difference was found regarding the duration of blood sampling between the two groups, even after stratifying the patients into the three age subgroups. There was no difference between the two groups in the success at the first attempt in blood sampling.

CONCLUSIONS: Routine use of VeinViewer{\textregistered} is not useful to reduce time of the procedure during venipuncture.

TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov, with number NCT03277092 , on September 8, 2017.

}, keywords = {Adolescent, Age Factors, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Infrared Rays, Lighting, Male, Phlebotomy, Time Factors}, issn = {1824-7288}, doi = {10.1186/s13052-018-0501-1}, author = {Conversano, Ester and Cozzi, Giorgio and Pavan, Matteo and Minute, Marta and Gortan, Elena and Montico, Marcella and Vecchi Brumatti, Liza and Ronfani, Luca and Barbi, Egidio} } @article {10800, title = {Inclusion cyst of anterior fontanelle.}, journal = {Arch Dis Child}, year = {2018}, month = {2018 Aug 21}, issn = {1468-2044}, doi = {10.1136/archdischild-2018-315727}, author = {Udina, Chiara and Calligaris, Lorenzo and Berti, Irene and Cattaruzzi, Elisabetta and Barbi, Egidio} } @article {10804, title = {Intranasal dexmedetomidine, as midazolam-sparing drug, for MRI in preterm neonates.}, journal = {Paediatr Anaesth}, volume = {28}, year = {2018}, month = {2018 08}, pages = {747-748}, issn = {1460-9592}, doi = {10.1111/pan.13454}, author = {Bua, Jenny and Massaro, Marta and Cossovel, Francesca and Monasta, Lorenzo and Brovedani, Pierpaolo and Cozzi, Giorgio and Barbi, Egidio and Demarini, Sergio and Travan, Laura} } @article {10508, title = {Intranasal Dexmedetomidine for Procedural Sedation in Children, a Suitable Alternative to Chloral Hydrate.}, journal = {Paediatr Drugs}, volume = {19}, year = {2017}, month = {2017 Apr}, pages = {107-111}, abstract = {

Sedation is often required for children undergoing diagnostic procedures. Chloral hydrate has been one of the sedative drugs most used in children over the last 3 decades, with supporting evidence for its efficacy and safety. Recently, chloral hydrate was banned in Italy and France, in consideration of evidence of its carcinogenicity and genotoxicity. Dexmedetomidine is a sedative with unique properties that has been increasingly used for procedural sedation in children. Several studies demonstrated its efficacy and safety for sedation in non-painful diagnostic procedures. Dexmedetomidine{\textquoteright}s impact on respiratory drive and airway patency and tone is much less when compared to the majority of other sedative agents. Administration via the intranasal route allows satisfactory procedural success rates. Studies that specifically compared intranasal dexmedetomidine and chloral hydrate for children undergoing non-painful procedures showed that dexmedetomidine was as effective as and safer than chloral hydrate. For these reasons, we suggest that intranasal dexmedetomidine could be a suitable alternative to chloral hydrate.

}, keywords = {Administration, Intranasal, Child, Chloral Hydrate, Dexmedetomidine, Humans, Hypnotics and Sedatives}, issn = {1179-2019}, doi = {10.1007/s40272-017-0217-5}, author = {Cozzi, Giorgio and Norbedo, Stefania and Barbi, Egidio} } @article {10567, title = {Intranasal Dexmedetomidine Sedation as Adjuvant Therapy in Acute Asthma Exacerbation With Marked Anxiety and Agitation.}, journal = {Ann Emerg Med}, volume = {69}, year = {2017}, month = {2017 01}, pages = {125-127}, abstract = {

We describe 2 patients with acute asthma exacerbation who were admitted to the emergency department (ED) with severe~agitation and restlessness as a prominent finding, for which bedside asthma treatment sedation with intranasal dexmedetomidine was performed. In both cases, dexmedetomidine allowed the patients to rest and improved tolerance to treatment. Dexmedetomidine is a unique sedative with an excellent safety profile and minimal effect on respiratory function. These properties render it particularly promising for the management of severe agitation in children admitted to the ED with acute asthma exacerbation.

}, keywords = {Acute Disease, Administration, Intranasal, Anxiety, Asthma, Child, Preschool, Dexmedetomidine, Emergency Service, Hospital, Female, Humans, Hypnotics and Sedatives, Infant, Psychomotor Agitation}, issn = {1097-6760}, doi = {10.1016/j.annemergmed.2016.08.005}, author = {Cozzi, Giorgio and Lega, Sara and Giorgi, Rita and Barbi, Egidio} } @article {1599, title = {Intranasal lidocaine and midazolam for procedural sedation in children.}, journal = {Arch Dis Child}, volume = {96}, year = {2011}, month = {2011 Feb}, pages = {160-3}, abstract = {

OBJECTIVE: To evaluate the safety and efficacy of a sedation protocol based on intranasal lidocaine spray and midazolam (INM) in children who are anxious and uncooperative when undergoing minor painful or diagnostic procedures, such as peripheral line insertion, venipuncture, intramuscular injection, echocardiogram, CT scan, audiometry testing and dental examination and extractions.

PATIENTS AND DESIGN: 46 children, aged 5-50 months, received INM (0.5 mg/kg) via a mucosal atomiser device. To avoid any nasal discomfort a puff of lidocaine spray (10 mg/puff) was administered before INM. The child{\textquoteright}s degree of sedation was scored using a modified Ramsay sedation scale. A questionnaire was designed to evaluate the parents{\textquoteright} and doctors{\textquoteright} opinions on the efficacy of the sedation. Statistical analysis was used to compare sedation times with children{\textquoteright}s age and weight.

RESULTS: The degree of sedation achieved by INM enabled all procedures to be completed without additional drugs. Premedication with lidocaine spray prevented any nasal discomfort related to the INM. The mean duration of sedation was 23.1 min. The depth of sedation was 1 on the modified Ramsay scale. The questionnaire revealed high levels of satisfaction by both doctors and parents. Sedation start and end times were significantly correlated with age only. No side effects were recorded in the cohort of children studied.

CONCLUSIONS: This study has shown that the combined use of lidocaine spray and atomised INM appears to be a safe and effective method to achieve short-term sedation in children to facilitate medical care and procedures.

}, keywords = {Administration, Intranasal, Anesthetics, Local, Anxiety, Child, Preschool, Conscious Sedation, Diagnostic Techniques and Procedures, Female, Humans, Hypnotics and Sedatives, Infant, Lidocaine, Male, Midazolam, Minimally Invasive Surgical Procedures, Nebulizers and Vaporizers, Nose Diseases, Prospective Studies}, issn = {1468-2044}, doi = {10.1136/adc.2010.188433}, author = {Chiaretti, Antonio and Barone, Giuseppe and Rigante, Donato and Ruggiero, Antonio and Pierri, Filomena and Barbi, Egidio and Barone, Giovanni and Riccardi, Riccardo} }