Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2000
Clinical TrialThe time-course of action and recovery of rocuronium 0.3 mg x kg(-1) in infants and children during halothane anaesthesia measured with acceleromyography.
This study compares the time-course of action of neuromuscular paralysis after 0.3 mg x kg(-1) of rocuronium during nitrous oxide-halothane anaesthesia in children of three different age groups. With appropriate approval and informed consent from the parents, 51 children, ASA I-II, scheduled for elective surgery requiring muscle relaxation, were studied. The children were assigned to three groups according to age: group 1, 0-6 months; group 2, 6-24 months; and group 3, > 24 months of age. ⋯ Group 1 and 2 showed no significant differences in recovery times. The RI was significantly prolonged in group 1 versus 3. The authors conclude that rocuronium 0.3 mg x kg(-1) during halothane anaesthesia causes more neuromuscular depression and has a longer duration of action in infants than in children older than 2 years.
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Paediatric anaesthesia · Jan 2000
Randomized Controlled Trial Clinical TrialThe adult Bullard laryngoscope as an alternative to the Wis-Hipple 1(1/2) in paediatric patients.
This prospective, randomized study was undertaken to compare the adult Bullard laryngoscope (BL) with the Wis-Hipple laryngoscope (WhL) in paediatric patients with regards to laryngeal view and time to intubation, and whether its efficacy was related to age or weight. Fifty patients scheduled for general anaesthesia between the ages of 1 and 5 years were examined. Patients were randomized into two groups: one group had an initial laryngoscopy via the WhL and then had a laryngoscopy and intubation using the BL; the second group had an initial laryngoscopy with the BL and then had a laryngoscopy and intubation using the WhL. ⋯ No relationship was found between the time to intubation and age or weight. In an occasional child, the BL provides a superior laryngeal view and provides a means for a successful intubation when a failure with the WhL occurs. Although intubation of children aged 1-5 years takes longer with a BL than a WhL, the adult BL complemented the WhL laryngoscope in paediatric patients.
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Paediatric anaesthesia · Jan 2000
The Newton valve revisited: an in-vitro study of ventilator circuit dead space.
A laboratory study was conducted to investigate the volume (length) of the ventilator circuit dead space (VCD) tubing at which dilution of an inspired gas by ventilator driving gas first occurs using three lung models. Various lengths of two VCD tubing materials [Portex (Sims Portex Ltd, Kent, UK) 10 mm bore smooth-walled silicon and Intersurgical (Wokingham, Berks, UK) 22 mm corrugated plastic] were interposed between a T-piece circuit and Nuffield 200 ventilator (Penlon, Abingdon, Oxon, UK) with a Newton valve attached. ⋯ Dilution of the inspired anaesthetic gases by ventilator driving gas may occur in paediatric practice if the VCD volume (length) is inadequate. This risk is greatest in the child.
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Paediatric anaesthesia · Jan 2000
Case ReportsAn unusual complication of a central venous catheter in a neonate.
The use of central venous catheters in neonates is associated with early and late complications. It is recognized that catheter tip migration and perforation of a viscus can occur at any time with a potentially fatal outcome. ⋯ The report highlights the serious morbidity arising from the use of central venous lines in neonates and stresses the importance of X-rays in establishing the correct position of all catheters. A sudden change in the condition of a patient should raise the suspicion of a catheter-related problem.
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Paediatric anaesthesia · Jan 2000
Comparative StudyImpact of infusion line compliance on syringe pump performance.
To determine the impact of infusion line compliance on the time to occlusion alarm (occlusion time) and the size of the subsequent occlusion release bolus, we studied three different infusion lines in combination with a 50-ml and 10-ml syringe. The mean occlusion time of the 50-ml syringe amounted to 20.3 +/- 0.28 min and increased to 26.2 +/- 0.19 min with the infusion with the infusion line yeielding the largest compliance (P<0.0001). ⋯ Occlusion times correlated strongly to be calculated estimated compliance of the syringe-infusion line assembly (Pearson's r=0.998, P<0.0001). Infusion line compliance has an important impact on time to occlusion, particularly when using small, low compliant infusion pump syringes.