Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2004
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia for adenotonsillectomy in children: a comparison of morphine, ketamine and tramadol.
Establishment of good analgesia is of major concern in the postoperative period following adenotonsillectomy. The aim of this study was to compare the effects of ketamine, morphine and tramadol on postoperative pain after adenotonsillectomy in children. ⋯ Morphine hydrochloride 0.1 mg x kg(-1) i.v. administered during induction of anaesthesia provides efficient pain relief in children undergoing adenotonsillectomy.
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Paediatric anaesthesia · Jul 2004
Randomized Controlled Trial Clinical TrialRofecoxib administration to paediatric patients undergoing adenotonsillectomy.
Rofecoxib is a selective COX-2 inhibitor that does not interfere with platelet function and is associated with fewer bleeding complications than other nonsteroidal anti-inflammatory agents (NSAIDs). Our aims were to evaluate the safety and the efficacy of rofecoxib administration to paediatric patients undergoing adenotonsillectomy (T&A). ⋯ Rofecoxib administration to paediatric patients undergoing T&A did not result in increased bleeding. Rofecoxib, however, was not found to decrease morphine use or improve pain scores prior to hospital discharge in T&A patients who received intraoperative morphine and acetaminophen.
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Paediatric anaesthesia · Jul 2004
Multicenter StudyAn evaluation of brainstem death documentation: the importance of full documentation.
With the introduction of the concept of brainstem death as acceptable proof that life has ended, rather than cessation of the beating heart, the process of determining brain death has to be rigorous to ensure maintenance of confidence in the definition. A recent study from South Thames in the UK revealed that only 44% of brainstem death documentation was complete at the time of referral to the transplant coordinator. The aim of our study was to see whether our documentation of brainstem death in paediatric practice complied with the UK Royal College's guidelines and to determine whether any changes are required to be instituted. ⋯ Documentation of adherence to the Royal Colleges, guidelines on brainstem death testing improved significantly between the two study periods as a consequence of major changes in practice within the PICU. With the appointment of dedicated intensive care consultants, care became largely consultant intensivist led and emphasis was placed on the documentation and completion of a single validated brainstem death proforma. It is essential to improve and maintain the quality of brainstem death test documentation in order to ensure the integrity of the process.
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Paediatric anaesthesia · Jul 2004
Use of spinal anaesthesia in paediatric patients: a single centre experience with 1132 cases.
Spinal anaesthesia has been used in children for over 100 years and in the last two decades its popularity for newborns and infants has increased, but there are still unanswered questions with the technique. ⋯ Spinal anaesthesia with hyperbaric bupivacaine is a feasible anaesthetic method in children for surgery in the lower part of the body.
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Paediatric anaesthesia · Jul 2004
Comparative StudyGenerating a learning curve for penile block in neonates, infants and children: an empirical evaluation of technical skills in novice and experienced anaesthetists.
Literature concerning learning curves for anaesthesiological procedures in paediatric anaesthesia is rare. The aim of this study was to assess the number of penile blocks needed to guarantee a high success rate in children. ⋯ Penile block in children is easily learned by residents. A steep learning curve was found. The success rate was over 93.5% after more than 40 blocks.