Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2004
Randomized Controlled Trial Comparative Study Clinical TrialIntraoperative ketorolac is an effective substitute for fentanyl in children undergoing outpatient adenotonsillectomy.
In this prospective randomized double-blind study, we compared the incidence of emesis and 48-h recovery profiles after a single dose of ketorolac vs fentanyl in dexamethasone-pretreated children undergoing ambulatory adenoidectomy and laser-assisted tonsillectomy (ADLAT). We evaluated the hypothesis that avoiding the use of opioids and replacing them with an equianalgesic dose of ketorolac, a nonsteroidal anti-inflammatory drug, would reduce the incidence of postoperative nausea and vomiting (PONV). ⋯ Ketorolac showed no advantage over fentanyl in reducing the incidence of PONV in children undergoing ADLAT.
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Paediatric anaesthesia · Apr 2004
Review Case ReportsManaging sedation withdrawal in children who undergo prolonged PICU admission after discharge to the ward.
Children who undergo a prolonged stay within the intensive care unit require adequate sedation and analgesia. During the recovery phase there will need to be a period of sedation withdrawal to prevent occurrence of an abstinence syndrome. We present a strategy developed within our hospital for managing this process which uses the resource of the Pain Service, along with guidelines to help prevent the development of withdrawal, and a plan for managing any signs of abstinence which occur.
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Paediatric anaesthesia · Apr 2004
Randomized Controlled Trial Clinical TrialThe cardiac analgesic assessment scale (CAAS): a pain assessment tool for intubated and ventilated children after cardiac surgery.
This study evaluated the reliability and validity of the Cardiac Analgesic Assessment Scale (CAAS) as a postoperative pain instrument for children after cardiac surgery. ⋯ This study provides evidence that postoperative pain in sedated and intubated children after cardiac surgery can be assessed reliably using a formal pain tool.
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Paediatric anaesthesia · Apr 2004
Gastric insufflation pressure, air leakage and respiratory mechanics in the use of the laryngeal mask airway (LMA) in children.
The objective of the present study was to evaluate the prelaryngeal position of the laryngeal mask airway (LMA(TM)) in children, and to determine the influence of mask positioning on gastric insufflation and oropharyngeal air leakage. ⋯ Clinically undetected LMA malpositioning is a significant risk factor for gastric air insufflation in children between 3 and 11 years, undergoing positive pressure ventilation, especially at inspiratory airway pressures above 17 cmH(2)O.