Paediatric anaesthesia
-
Postoperative conditions in hospital and at home were evaluated in 200 paediatric daycase patients by using questionnaires and telephone interviews. Pain was assessed by behaviour observation or a faces rating scale depending on age. Anaesthetic methods, nausea/vomiting, analgesics and parents' aspects were also recorded. ⋯ The increased degree of pain at home was especially pronounced after regional anaesthesia. The total incidence of nausea/vomiting was 28% and fentanyl caused nausea and vomiting in a significantly higher proportion of cases. The study points out that immediate postoperative comfort obtained by prophylactic analgesia needs to be followed by analgesics given on a continuous basis for the first days after surgery.
-
Paediatric anaesthesia · Jan 1999
The effect of syringe size on the performance of an infusion pump.
This study investigated the effect of using three different sized syringes on the accuracy of fluid delivery when using an infusion pump at low infusion rates (1 ml.h-1). The study also measured the influence of the syringe size on the time to occlusion alarm, and on the size of the subsequent bolus dose that might be infused after relief of the occlusion which triggered the alarm. The use of a larger size syringe was found not to affect the accuracy of infusate delivery, but delayed the time to occlusion alarm and increased the size of the postocclusion bolus dose.
-
The perioperative management of a 14-year-old girl, suffering from the muscular disorder rigid spine syndrome, is presented. The anaesthetic implications with regard to possible difficult intubation, cardiac involvement, malignant hyperthermia, neuromuscular blocking agents, and postoperative recovery are discussed.
-
Paediatric anaesthesia · Jan 1999
Case ReportsExtrapyramidal side-effects from droperidol mixed with morphine for patient-controlled analgesia in two children.
We report two cases of extrapyramidal reactions occurring in children following the use of droperidol in combination with morphine for patient-controlled analgesia (PCA). Symptoms appeared 38 and 27 h, respectively, after commencement and after a total dose of 0.14 mg.kg-1 and 0.17 mg.kg-1, respectively. Although effective and safe in adult patients, we recommend caution with the use of droperidol-morphine mixtures for PCA in paediatric patients.
-
We report a case of severe accidental hypothermia (24.8 degrees C) in a seven-year-old child due to prolonged exposure to low temperatures and temporary contact with river water. When the patient was seen in hospital, bradycardia (30.min-1), bradypnoea (5. min-1), scarcely reacting pupils, and Glasgow Coma Scale=3 were noted. For rewarming minimally invasive techniques (humidified warmed gases and intravenous solutions at 40 degrees C) were employed with a very successful outcome.