Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1996
Changes in carbon dioxide tension and oxygen saturation during deep sedation for paediatric cardiac catheterization.
The purpose of this observational study was to determine whether hypercarbia or oxygen desaturation occurred during our current regimens of deep sedation or general anaesthesia of infants and children undergoing cardiac catheterization. Data were gathered prospectively from 50 consecutive infants and children aged 4 months to 12 years undergoing cardiac catheterization. Several anaesthetists used the following regimens, which were not randomized: 1) propofol. 1.5-2.0 mg.kg-1 and fentanyl 1 microgram.kg-1 IV over 2 min for induction, followed by propofol infusion of 100-150 micrograms.kg-1.min-1; 2) fentanyl 2-3 micrograms.kg-1 and midazolam 0.1-0.2 mg.kg-1 IV over 10-15 min; 3) ketamine 8 mg.kg-1 IM, or 4) same as regimens 1 or 2, plus pancuronium, intubation and controlled ventilation. ⋯ The three regimens employing spontaneous ventilation through the natural airway were associated with both statistically and clinically significant increases in PetCO2 and decreases in SpO2. This raises the possibility that acute exacerbation of PAP and PVR may occur in pulmonary hypertensive patients. In contrast, PetCO2 and SpO2 did not change significantly from baseline in the controlled ventilation group.
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Paediatric anaesthesia · Jan 1996
The rectus sheath block in paediatric anaesthesia: new indications for an old technique?
The rectus sheath block has been used with success for postoperative analgesia in adults. This paper reviews the anatomy of the rectus sheath, and presents our initial experience of using the block to provide intra- and postoperative analgesia in children having repair of umbilical and paraumbilical hernia. The rectus sheath block appears to be a useful technique in children, particularly for paediatric day-cases surgery.
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Paediatric anaesthesia · Jan 1996
Case ReportsRight bevelled tube for selective left bronchial intubation in a child undergoing right thoracotomy.
Left bronchial intubation was used to achieve selective left lung ventilation in a five-year-old child, undergoing thoracotomy for excision of a hydatid cyst of the right lung. Intubation of the left main stem bronchus was easily achieved from the first attempt by a right bevelled tracheal tube. ⋯ One lung ventilation using 1-2% halothane in 100% oxygen was associated with Spo2 that ranged between 95-97%, and endtidal PETCO2 ranging between 3.9-4.5 kPa (30-35 mmHg). Following excision of the hydatid cyst, the tube was withdrawn above the carina into the trachea, and two lung ventilation was continued until the end of surgery.