Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1995
Comparative StudyIntrathecal morphine (ITM) for postoperative pain control in children: a comparison with nalbuphine patient controlled analgesia (PCA).
This is a retrospective study covering the ten-year period 1984-1993. Single shot spinal morphine (ITM) is compared with PCA nalbuphine for postoperative pain relief in children having abdominal or thoracic procedures. The records of 52 patients meeting selection criteria were examined. ⋯ No difference in duration of hospital stay or ICU stay could be demonstrated. We conclude that ITM provides better pain relief, without more serious complications, than PCA nalbuphine. We recommend it as a safe, effective technique to treat postoperative pain in children following thoracic or upper abdominal procedures.
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A new regimen for postoperative analgesia after thoracic surgery is proposed. Eight children received an interpleural infusion using bupivacaine 0.1% in a regimen from 0.5 ml.kg-1.h-1 up to 1 ml.kg-1.h-1, for 48 h according to the pain scores. The plasma levels after 24 h and 48 h were measured as well as the pleural level and in two patients the free fraction of plasma bupivacaine and the plasma PPX (a metabolite of bupivacaine) and one patient the orosomucoid (main plasma protein involved in bupivacaine protein binding) were also measured pre and postoperatively. The results shows the safety of such a regimen, for two days of postoperative analgesia.
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Paediatric anaesthesia · Jan 1995
Case ReportsThe laryngeal mask airway for fibreoptic bronchoscopy in children.
A size 2 laryngeal mask airway (ID 7 mm) was used for general anaesthesia during fibreoptic bronchoscopy in a six-year-old child. The mask permitted the use of an adult bronchoscope with an external diameter of 5 mm. Throughout bronchoscopy, adequate controlled ventilation could be achieved easily without excessive air leak or airway resistance; the Spo2 was always > 97%, and the end-tidal Pco2 ranged between 3.9-4.5 kPa (30-35 mmHg).
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Paediatric anaesthesia · Jan 1995
Biography Historical ArticleMagill's endotracheal catheter device for use during repair of cleft lip and palate.
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Paediatric anaesthesia · Jan 1995
Postoperative nausea and vomiting in paediatric surgical inpatients.
A prospective study of postoperative nausea and vomiting (PONV) was conducted in 415 children presenting for inpatient surgery. The overall incidence of PONV was 18.1%). The highest incidence was in children undergoing ENT procedures and increased with age. Avoidance of intraoperative opioids and the use of local anaesthesia and/or non-steroidal anti-inflammatory drugs reduced the incidence of nausea and vomiting postoperatively.