RESUMO
A persistent left superior vena cava (PLSVC) is a congenital anomaly of the systemic venous system. This anomaly is often discovered as an incidental result during central venous catheterization passing through the left subclavian or the left internal jugular vein. We report two cases of PLSVC in pediatric patients.
Assuntos
Cateterismo Venoso Central/instrumentação , Cateteres de Demora , Malformações Vasculares/diagnóstico , Veia Cava Superior/anormalidades , Pré-Escolar , Átrios do Coração/diagnóstico por imagem , Humanos , Achados Incidentais , Recém-Nascido , Masculino , Flebografia/métodos , Tomografia Computadorizada por Raios X , Malformações Vasculares/diagnóstico por imagem , Veia Cava Superior/diagnóstico por imagemRESUMO
For many years the opportunity of reducing the pain of birth through the administering of drugs (e.g. local anesthetics and opioids) into the epidural space has been known. Numerous studies have been conducted throughout the years to clarify whether the use of the epidural has resulted in a higher incidence of cesarean sections but it appears that this is due more to maternal-fetal factors than it is to the epidural. In this study, we have outlined the experience of the Anesthesia and Intensive Care Unit of an Italian Children's Hospital in which approximately-2500 births take place every year and in which there is an active birth analgesia service which requires the presence of a dedicated anesthetist.
Assuntos
Analgesia Epidural/métodos , Analgesia Epidural/estatística & dados numéricos , Analgesia Obstétrica/métodos , Cesárea/estatística & dados numéricos , Trabalho de Parto , Adulto , Analgesia Epidural/efeitos adversos , Analgesia Obstétrica/estatística & dados numéricos , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Anestésicos Locais/administração & dosagem , Anestésicos Locais/efeitos adversos , Relação Dose-Resposta a Droga , Feminino , Humanos , Incidência , Recém-Nascido , Trabalho de Parto/efeitos dos fármacos , Ocitocina/administração & dosagem , Ocitocina/efeitos adversos , Gravidez , Resultado da Gravidez/epidemiologiaRESUMO
The use of central venous catheters (CVCs) represents an important step in the management of the surgical, onco-hematology and critically ill patients. CVCs in neonates, like in adult patients, are mainly used to infuse hyperosmolar solutions, to take blood samples and for hemodynamic monitoring. The need for CVCs is higher in neonates than in adults. Poor peripheral access and the high demand for IV access and blood samples are already valuable indications for a CVC.