Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1996
Case ReportsRespiratory depression following administration of low dose buprenorphine as postoperative analgesic after fentanyl balanced anaesthesia.
Opioids are among the most ancient and widely used drugs in anaesthesiology. The pharmacology of opioid analgesics and their receptors is a complex and not fully understood matter; even more complex are the interactions between different classes of opioids at both molecular and clinical levels. ⋯ This paper contains a clinical observation of respiratory depression following the administration of buprenorphine as postoperative analgesic after balanced anaesthesia with fentanyl. The observed case is interpreted in the light of the pharmacokinetics and pharmacodynamics of the different classes of opioid drugs (agonists, agonists-antagonists, antagonists) and of the interactions with their respective receptors.
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Paediatric anaesthesia · Jan 1996
Case ReportsThe use of ondansetron to treat pruritus associated with intrathecal morphine in two paediatric patients.
Intrathecal morphine is an effective technique for providing postoperative analgesia after major surgical procedures in children. Pruritus is a common side effect associated with intrathecal morphine. We report two patients who experienced significant pruritus associated with intrathecal morphine administration and were successfully treated with ondansetron. Ondansetron appears to be a beneficial and safe method of relieving pruritus associated with intrathecal morphine.
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialOral transmucosal ketamine: an effective premedication in children.
The oral cavity offers a simple, painless way of drug administration. For this reason, we used oral transmucosal ketamine (5-6 mg.kg-1) for premedication in 25 children and compared it with intranasal ketamine (5-6 mg.kg-1), placebo and intramuscular ketamine (5-6 mg.kg-1). ⋯ The lollipops produced a slight increase in gastric volumes but did not affect gastric pH. In conclusion OTK has been shown to be an effective, harmless preoperative medication in paediatric patients.
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialBehavioural changes and children's memories after intravenous, inhalation and rectal induction of anaesthesia.
Ninety two-to-seven-year-old children admitted for routine day case ENT operations were randomly allocated to have either intravenous thiopentone (group I), halothane inhalation (group II) or rectal methohexitone (group III) for anaesthesia induction. Using a postoperative questionnaire, the parents evaluated the changes in the child's behaviour one day, one week and one month after the operation. ⋯ Although the children in group II behaved most calmly during the induction they had significantly more negative memories of the induction of anaesthesia (six children in group II vs two in group I and one in group III) and of the hospital in general (17 in group II vs 11 in group I and eight in group III) than children in the other groups. Judging from memories of young children, intravenous and rectal inductions are less distressing to them than inhalational induction.
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Paediatric anaesthesia · Jan 1996
Patient controlled analgesia (PCA) in paediatric surgery: a prospective study following laparoscopic and open appendicectomy.
Patient controlled analgesia (PCA) has not yet gained universal acceptance for the management of postoperative pain in paediatric surgery. In a prospective study we evaluated feasibility and complications of PCA following 90 cases of laparoscopic or open appendicectomy. ⋯ Assessment of application protocols showed, that the consumption of analgesics was significantly reduced following laparoscopic appendicectomy (P < 0.05). PCA is a safe and feasible method for the management of postoperative pain in children and PCA recording provides an excellent insight into the consumptional behaviour of patients, enabling staff to evaluate postoperative pain for various procedures.