Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2003
Case ReportsIntraoperative transoesophageal echocardiography in a low birth weight neonate with atrioventricular septal defect.
An 18-day-old male neonate (45 cm, 1.8 kg) with a history of cyanosis and congestive heart failure from an atrioventricular septal defect (AVSD) with a large left-to-right shunt was scheduled for surgical repair of the AVSD. After routine induction of anaesthesia with fentanyl and vecuronium, a 4.5-mm diameter transoesophageal echocardiography (TOE) probe was inserted into the oesophagus, and systematic echocardiographic evaluation was performed during surgery. After cardiopulmonary bypass was stopped, intraoperative TOE revealed mild residual mitral valve regurgitation. ⋯ The patient's cardiac output was low in the postoperative intensive care unit. TOE was performed the next day to detect the source of this problem, revealed severe regurgitation compared with that observed intraoperatively. TOE was useful for evaluation of the residual mitral valve regurgitation, and we reconfirmed the importance of continuous monitoring even in a low birthweight neonate undergoing repair of a complete AVSD.
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Paediatric anaesthesia · Oct 2003
Comment Letter Case ReportsPostintubation tracheal stenosis in an 11-year-old boy: a surgical and anaesthetic challenge.
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Paediatric anaesthesia · Oct 2003
Randomized Controlled Trial Clinical TrialLaryngeal mask insertion in children: a rational approach.
Various techniques of laryngeal mask airway (LMATM) insertion have been described in adults but only limited clinical trials have been conducted in children despite a varying range in success rate by the recommended method. ⋯ A partially inflated cuff inserted by the lateral route is a better method of insertion in children and grade 3 fibreoptic views can be associated with a significant build up of carbon dioxide in children breathing spontaneously.
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Paediatric anaesthesia · Oct 2003
Randomized Controlled Trial Comparative Study Clinical TrialRemifentanil vs alfentanil in the total intravenous anaesthesia for paediatric abdominal surgery.
Our aim was to investigate whether total intravenous anaesthesia (TIVA) with remifentanil and alfentanil would ensure appropriate analgesia and recovery conditions in anaesthesia for children undergoing abdominal surgery. ⋯ Remifentanil provides a more rapid recovery and adequate postoperative analgesia after TIVA for paediatric abdominal surgery, compared with alfentanil.