Paediatric anaesthesia
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We report a case of perioperative management of a neonate with popliteal pterygium syndrome complicated by interalveolar syngnathia. Syngnathia were excised in the operating room without a major anaesthetic. We discuss our management of this case, as well as other possible strategies to secure the airway in neonates with syngnathia. We also reviewed the literature regarding airway management in presence of syngnathia in similar situations.
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Paediatric anaesthesia · Jan 2003
Cerebrovascular carbon dioxide reactivity in children anaesthetized with propofol.
Propofol, by virtue of its favourable pharmacokinetic profile, is suitable for maintenance of anaesthesia by continuous infusion during neurosurgical procedures in adults. It is gaining popularity for use in paediatric patients. To determine the effects of propofol on carbon dioxide cerebrovascular reactivity in children, middle cerebral artery blood flow velocity was measured at different levels of endtidal (PECO2) by transcranial Doppler sonography. ⋯ This study demonstrates that cerebrovascular CO2 reactivity is maintained over PECO2 values of 3.3, 5.2 and 7.2 kPa (25, 40 and 55 mmHg) in healthy children anaesthetized with propofol.
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Paediatric anaesthesia · Jan 2003
Ventilatory effects of morphine infusions in cyanotic versus acyanotic infants after thoracotomy.
Previous studies show that the age of an infant affects morphine clearance but that ventilatory effects from morphine infusions are similar at the same morphine steady-state concentration in infants and children after surgery. The presence of cyanotic heart disease in infants receiving postoperative morphine infusions was studied for its potential effect on ventilatory effort. ⋯ Morphine i.v. infusions given to infants following thoracotomy show the same ventilatory effects in infants with cyanotic heart disease as in acyanotic infants. Age is the more important determinant of morphine response by its effect on morphine clearance than cyanosis in infants aged less than 3 months.
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Paediatric anaesthesia · Jan 2003
Comparative StudyHaemodynamic changes during high spinal anaesthesia in children having open heart surgery.
This prospective series examined the haemodynamic effects of high spinal anaesthesia in combination with light general anaesthesia in infants and children undergoing open heart surgery who were candidates for immediate or early postoperative extubation. ⋯ High spinal anaesthesia with hyperbaric tetracaine and morphine in combination with light general anaesthesia is well tolerated haemodynamically by the paediatric population studied.
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Paediatric anaesthesia · Jan 2003
Case ReportsCongenital laryngotracheo-oesophageal cleft: successful ventilation with the Laryngeal Mask Airway.
A congenital laryngotracheo-oesophageal cleft is a rare airway malformation which results from incomplete separation of the larynx and trachea from the hypopharynx and oesophagus. Patients usually present with stridor, aspiration and cyanosis associated with feeding. ⋯ Unless an appropriate diagnostic approach is taken, the diagnosis can be missed. The successful ventilation of a neonate with the Laryngeal Mask Airway is described.