Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2003
Randomized Controlled Trial Clinical TrialThe dose of caudal epidural analgesia and duration of postoperative analgesia.
Single dose caudal epidural is commonly utilized for postoperative analgesia in children. Previous studies have determined the optimal concentration of local anaesthetic, and the minimal volume to produce a desired dermatomal distribution. However, none has sought the optimal volume to administer. The specific aim of this study was to determine whether the volume of caudal epidural local anaesthetic influenced the duration of postoperative analgesia. ⋯ Increasing local anaesthetic dose and volume do not increase the duration of postoperative analgesia of caudal epidural in children undergoing inguinal herniorraphy.
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Paediatric anaesthesia · Jun 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison of 0.2% ropivacaine and 0.25% bupivacaine for axillary brachial plexus blocks in paediatric hand surgery.
The purpose of this study was to compare the use of ropivacaine 0.2% with bupivacaine 0.25% for axillary brachial plexus block in children undergoing hand surgery. ⋯ Ropivacaine 0.2% is as effective as bupivacaine 0.25% for axillary brachial plexus blocks in children undergoing hand surgery.
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Paediatric anaesthesia · Jun 2003
Randomized Controlled Trial Clinical TrialDouble-blind randomized placebo-controlled trial of the effect of ketamine on postoperative morphine consumption in children following appendicectomy.
Ketamine has an opioid sparing effect following surgery in adults. This study investigated whether a similar effect is seen following appendicectomy in paediatric patients. ⋯ In this paediatric population intravenous ketamine did not have a morphine sparing effect. The increased incidence of side-effects, especially hallucinations, reported by patients given a ketamine infusion may limit the further use of postoperative ketamine in children.
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Paediatric anaesthesia · Jun 2003
Clinical TrialMeasurement of cerebral oxygenation state in anaesthetized children using the INVOS 5100 cerebral oximeter.
Near-infrared spectroscopy is a developing technique for monitoring cerebral oxygenation during anaesthesia. The aim of this study was to evaluate absolute values of cerebral oxygenation during stable anaesthesia conditions in otherwise healthy children using the recently introduced INVOS 5100 cerebral oximeter with a paediatric and adult sensor and to compare them with values obtained from the NIRO 300 oximeter. ⋯ The large range and the poor agreement of cerebral oxygenation values between the two oximeters makes it difficult to define a normal value. Cerebral oxygenation readings by these monitors, based on one single point measurement during anaesthesia, should be viewed with caution. Actually, there may be little indication for routine use of such monitoring during general anaesthesia.
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Paediatric anaesthesia · Jun 2003
Case ReportsAnaesthesia for an adolescent with mitochondrial encephalomyopathy-lactic acidosis-stroke-like episodes syndrome.
Anaesthesia for patients with mitochondrial disorders occurs with regularity, either for a diagnostic or therapeutic procedure associated with the syndrome or for unassociated surgery. We report the case of a 17-year-old boy with mitochondrial encephalomyopathy-lactic acidosis-stroke-like episodes (MELAS) syndrome who underwent a laparotomy for fundoplication. The potential hazards of anaesthesia for this patient, and the steps taken to avoid them, are discussed.