Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1998
Case ReportsProlonged mivacurium neuromuscular block in children.
The authors report two cases of prolonged neuromuscular block after administration of mivacurium in children with previously undiagnosed plasma cholinesterase deficiency related to homozygous atypical genotype. Their anaesthetic management is described as well as determination of the phenotype of both children and their family.
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Paediatric anaesthesia · Jan 1998
Case ReportsThe Univent tube for single-lung ventilation in paediatric patients.
A Univent bronchial blocker tube was used in a ten-year-old patient undergoing videothoracoscopy. Paediatric Univent tubes offer an alternative to balloon-tipped catheters for providing single-lung ventilation (SLV) in children too small for adult size double-lumen tubes.
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Paediatric anaesthesia · Jan 1998
The usefulness of routine preoperative laboratory tests for one-day surgery in healthy children.
Since 1984, laboratory tests have not been routinely required for healthy paediatric patients scheduled for one-day surgery in our Paediatric Surgery Department. We reviewed the medical charts of all children ASA physical status 1 and 2 who underwent a minor surgical procedure in the last 15 years. We excluded all former preterm infants of less than 60 weeks postconceptual age. ⋯ The following data were collected: demographic data, ASA physical status classification, surgical procedure, anaesthetic technique, major and minor complications, length of hospital stay, the difference between the expected length of hospitalization and the actual length, number and reasons for cancellations of surgery. On the basis of our experience we believe that a thorough clinical assessment of the patient is more important than routine preoperative laboratory screening, which should be required only when justified by real clinical indications. Moreover, this practice eliminates unnecessary costs without compromising the safety and the quality of care.
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Paediatric anaesthesia · Jan 1998
Paediatric cardiac anaesthesia in a developing country. Guatemala Heart Team.
During the week of October 15-24, 1995 a team of 65 medical, anaesthesiology, surgical, nursing and paramedical personnel travelled to Guatemala City, Guatemala to perform cardiac surgery on children with complex congenital and acquired valvular heart disease. During this mission 42 patients had their lesions surgically repaired. Cardiopulmonary bypass was required in 36 cases. ⋯ There was no intraoperative anaesthetic morbidity nor postoperative respiratory complications. No patients was reintubated after planned extubation. Cardiac surgery in paediatric age patients can safely be performed in developing countries if close attention is paid to proper patient selection and one maintains the standards of care practised in developed countries.
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Paediatric anaesthesia · Jan 1998
Case ReportsSlow induction with sevoflurane was associated with complete atrioventricular block in a child with hypertension, renal dysfunction, and impaired cardiac conduction.
We describe the appearance of complete atrioventricular block (CAVB) with sevoflurane and nitrous oxide during the slow induction in a ten-year-old male patient with hypertension, renal dysfunction, and impaired cardiac conduction. Sinus rhythm was restored following the washout of the anaesthetic gas. And CAVB recurred after the subcutaneous injection of lignocaine. The present report shows that sevoflurane should be treated with care like other inhalational anaesthetics as regards the effect on cardiac conduction.