Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2001
Case ReportsA technique for maintenance of airway access in infants with a difficult airway following tracheal extubation.
Tracheal extubation of patients with a difficult airway represents a challenge to anaesthesiologists and intensive care physicians. While a variety of techniques designed to maintain access to the airway in case of the need for tracheal reintubation have been described in adults, no reports have been published in infants and young children. We describe an approach to this issue in a young child with severe micrognathia.
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There are no reports of the parental perceptions of comfort during the mechanical ventilation of children. We have assessed the quality of sedation in 28 mechanically ventilated children and compared these results to an overall parental assessment of comfort, obtained by postal questionnaire. ⋯ Parents appear to become more satisfied with the degree of comfort of their children as the duration of mechanical ventilation increases, which is an effect that may have an important bearing on communication between parents and health professionals. Our results also suggest that the commonly used sedation regime of midazolam and morphine is less effective in younger children.
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Paediatric anaesthesia · Jan 2001
Case ReportsDifficult airway management of a child impaled through the neck.
We report the difficult airway management of a child impaled through the neck by a wooden plant support. The various options are discussed and the involvement of experienced personnel together with a clear preformulated plan of action is stressed.
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Paediatric anaesthesia · Jan 2001
Case ReportsContinuous axillary block for upper limb surgery in a patient with epidermolysis bullosa simplex.
We report the use of continuous regional block with light general anaesthesia in epidermolysis bullosa simplex. A 4-year-old girl suffering from florid epidermolysis bullosa simplex was scheduled for external fixator (JESS) for manus valgus deformity of the left forearm. Haemoglobin was 7.6 g.dl(-1) and blood chemistry was normal. ⋯ The axilla remained free of problems. Continuous peripheral plexus or nerve blocks can be an option in these difficult patients, and can minimize the amount of general anaesthesia along with problems of airway handling and potential subsequent mucosal lesions. The postoperative period was pain free and comfortable.