Sabine Kost-Byerly

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The exstrophy-epispadias complex is a rare congenital malformation of the genitourinary system, abdominal wall muscles, and pelvic structures. Modern surgical repairs focus on reconstruction of the bladder and its adjacent structures, with the goal of achieving urinary continence, a satisfactory cosmetic result, and a high quality of life. Complex surgery(More)
UNLABELLED Continuous epidural infusions are widely used for postoperative analgesia in children. We prospectively studied the incidence of bacterial colonization of caudal and lumbar epidural catheters, as well as the incidence of serious systemic and local infection, in 210 children after short-term epidural analgesia. Using aseptic technique, epidural(More)
The pain of vaso-occlusive crisis in patients with sickle cell disease is excruciating, incapacitating, and sometimes refractory to even the most advanced analgesic treatments. A comprehensive, multimodal approach to therapy that includes education, cognitive therapies, anti-inflammatory drugs, opioids, and psychostimulant adjuvant drugs has been presented.(More)
Increased knowledge of the pathophysiology of pain in children and an improved understanding of the pharmacology and pharmacodynamics of multiple agents have provided the clinician with a wide variety of tools to treat postoperative pain in children. The interest in a multimodal approach is kindled by the realization that the combination of a number of(More)
UNLABELLED Iatrogenic errors producing serious and often preventable injury occur frequently in hospitalized patients, particularly in children. Little is known about the epidemiology of analgesic medication errors in patients being discharged from the hospital. The goal of this study was to describe the epidemiology of controlled substance prescription(More)
OBJECTIVE Reconstruction of bladder exstrophy in newborn infants requires immobilization, sedation and pain management to prevent distracting forces from compromising the repair. We present a 6-year review of our experience. SUBJECTS AND METHODS We reviewed the perioperative management of newborn infants undergoing reconstruction between November 1999 and(More)
Celiac plexus blockade with ethanol is a widely accepted modality of pain control for adults with cancer pain. The role of interventional strategies in children is less well established. A 7-year-old child with abdominal pain secondary to a Wilms tumor was treated with neurolytic celiac plexus blockade. This resulted in control of abdominal pain for close(More)
Opioids are frequently associated with side effects such as nausea, vomiting, and pruritus. We hypothesized that a prophylactic, continuous small-dose naloxone infusion would reduce the incidence of opioid-induced side effects without affecting analgesia or opioid consumption. In this prospective, double-blind, randomized, controlled clinical trial, we(More)
UNLABELLED Over the past 5 yr, we have treated nonsurgical and postoperative pain in children <6 yr of age by using a patient-controlled analgesia pump to deliver small-dose continuous IV opioid infusions supplemented by parent- and nurse-controlled opioid bolus dosing. We call this technique parent-/nurse-controlled analgesia (PNCA). Because the safety and(More)