Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1999
Clinical TrialAxillary brachial plexus block for perioperative analgesia in 250 children.
A cannula technique for axillary brachial plexus block in combination with general anaesthesia has been in use since 1994 for children undergoing surgical correction of congenital hand anomalies. During a 4-year period data were collected on 250 procedures in 185 patients of median age 3 years detailing the block technique and the intraoperative and postoperative analgesic requirements. ⋯ Postoperative pain was controlled in this series with oral analgesia in all but six patients who received parenteral codeine. It is proposed that a cannula technique is an effective and safe method of producing axillary brachial plexus block in children.
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Paediatric anaesthesia · Jan 1999
Case ReportsSpinal anaesthesia and meningitis in former preterm infants: cause-effect?
Meningitis associated with spinal anaesthesia is a rare but well-known complication. We report on a case of fatal bacterial meningitis following spinal anaesthesia in a former preterm infant. ⋯ Former preterm infants represent a high-risk population because of their susceptibility to group B streptococcal meningitis at this age as documented in a second case. Therefore we discuss whether meningitis was consequential or coincidental with spinal anaesthesia and could have been prevented by more comprehensive preoperative laboratory screening or prophylactic antibiotics.
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We present the case of a nine-year-old boy afflicted with Ondine's curse, who developed complete atrioventricular heart block after a single bolus of propofol for induction of anaesthesia for strabismus surgery. Ondine's curse, the other name for congenital central hypoventilation syndrome, is characterized by a generalized disorder of autonomic function. ⋯ Heart block has been documented after propofol bolus use in adults but, to our knowledge, not in children. It would appear that propofol is not a good choice for anaesthesia in congenital central hypoventilation syndrome.
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Paediatric anaesthesia · Jan 1999
Comparative StudyThe influence of breathing system filters on paediatric capnography.
Breathing system filters are in common use during paediatric anaesthesia. Expired gas sampling from the patient side of these filters may contaminate and saturate the sampling line, while sampling from the machine side may cause underestimation of end-tidal carbon dioxide (PECO 2). ⋯ PECO 2 was higher at the patient side of the filter in both ventilated and spontaneously breathing groups (P<0.002 for each). The bias in measuring at the machine side of the filter was significantly greater in the spontaneously breathing children as compared with the mechanically ventilated children (-1.8 vs -0.7 kPa; P<0.004).
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Paediatric anaesthesia · Jan 1999
Case ReportsA different under vision approach to a difficult intubation.
A simple and safe technique of intubation with minimal discomfort to the patient using a nasopharyngeal airway, fibreoptic bronchoscope and guide wire in a three-year-old is presented.