Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of halothane and isoflurane for gaseous induction of anaesthesia in infants.
Sixty-four ASA 1 and 2 infants between the ages of 44 weeks postconceptual age and one year presenting for routine, elective surgery were randomly anaesthetized with either 3% halothane in oxygen (Group H) or 5% isoflurane in oxygen (Group I). Patients in Group I took a mean (SD) time of 70.1(13.6) s to loss of eyelash reflex and 80.0 (13.5) s to tolerating the face mask, compared with 80.2 (17.7) s and 93.4 (20.5) s in Group H (P=0.028 and 0.0072, respectively). There were no significant differences between the groups for preinduction or induction state, lowest oxygen saturation, or the incidence of airway related complications or interventions. This study demonstrates that 5% isoflurane in oxygen induces anaesthesia in infants more quickly than 3% halothane in oxygen, without any increase in the incidence or severity of airway-related complications.
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Paediatric anaesthesia · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialRopivacaine 0.25% compared with bupivacaine 0.25% by the caudal route.
We compared in a randomized double-blind study, the postoperative analgesia and degree of motor block produced by the new local anaesthetic ropivacaine, with bupivacaine, for caudal anaesthesia in children. Eighty children, 2-5-years-old, ASA I, received one of two local anaesthetics; either ropivacaine 0.25% (1.0 ml x kg(-1)) or bupivacaine 0.25% (1.0 ml x kg(-1)). They were sedated with a continuous infusion of propofol (200 microg x kg(-1) min(-1). ⋯ The ropivacaine group showed a shorter duration of motor block than the bupivacaine group (P<0.05). The first postoperative analgesic requirement was a mean (sd) of 5 h+/-4.32 after the operation in the ropivacaine group and 5 h+/-3.81 for the bupivacaine group. These findings suggest that caudal anaesthesia with ropivacaine 0.25% in paediatric patients can be effective, with less motor blockade in the postoperative period.
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Paediatric anaesthesia · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of ketamine on 0.25% and 0.125% bupivacaine for caudal epidural blockade in children.
Forty boys aged from one to five years undergoing orchidopexy were randomly allocated to receive one of two solutions for caudal epidural injection. Group A received 1 ml.kg-1 of 0.125% bupivacaine with ketamine 0.5 mg.kg-1 and Group B received 1 ml.kg-1 of bupivacaine 0.25% with ketamine 0.5 mg.kg-1. ⋯ The time taken to recover the ability to walk was a median of two h in Group A and three h in Group B (P<0.05). There were no differences between the groups in the incidence of urinary retention or postoperative sedation.
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Paediatric anaesthesia · Jan 1999
Randomized Controlled Trial Clinical TrialPrevention of postoperative vomiting with granisetron in paediatric patients with and without a history of motion sickness.
A history of motion sickness is one of the patient-related factors associated with postoperative emesis. This prospective, randomized, double-blind, placebo-controlled study was undertaken to assess the efficacy of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, for preventing postoperative vomiting after tonsillectomy in 120 children with (n = 60) and without (n = 60) a history of motion sickness. ⋯ No clinically serious adverse effects due to the study drug were observed in any of the groups. In conclusion, prophylactic antiemetic therapy with granisetron is effective for preventing postoperative emesis in children with a history of motion sickness as well as in those without it.
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Paediatric anaesthesia · Jan 1999
Comparative Study Clinical TrialComparison of endtidal CO2 and arterial blood gas analysis in paediatric patients undergoing controlled ventilation with a laryngeal mask or a face mask.
Endtidal CO2 (PECO2) and arterial blood gas tensions were compared between laryngeal mask (LMA) and face mask (FM) ventilation in paediatric outpatients. Following premedication with midazolam, anaesthesia was induced with either thiopentone or isoflurane and atracurium. Anaesthesia was maintained with N2O, O2 and isoflurane. ⋯ The mean PaCO2 values in the FM group were 41.3+/-8.1 and 43.4+/-8.9 mmHg; and PaCO2 -PECO2 were 5.3+/-3.6 and 8.8+/-7.0 mmHg, respectively. These values were lower in the LMA group (P< 0.05). We have concluded that monitoring of PECO2 is more reliable for estimating blood gas values during controlled ventilation with a LMA than a face mask.