Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2005
Case ReportsTotal spinal anesthesia during combined general-epidural anesthesia in a 7-year-old child.
Total spinal anesthesia (TSA) is a rare complication of lumbar epidural anesthesia through inadvertent spinal injection of local anesthetics following an undiagnosed dural breach or spinal placement of the catheter. TSA has rarely been reported in children. ⋯ Recent previous lumbar punctures and intrathecal chemotherapy for Burkitt's lymphoma at the same level may have facilitated dural breach. Epidural anesthesia should not be attempted at the same intervertebral level as prior recent lumbar punctures.
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Paediatric anaesthesia · Jan 2005
Sevoflurane sedation in infants undergoing MRI: a preliminary report.
Stillness during natural sleep after feeding may not be sufficient for successful magnetic resonance imaging (MRI) in small infants less than 5 kg. Sedation, using an oral agent, is often successful although the timing and depth of sedation is variable. In contrast anesthesia is always effective but is invasive and is associated with postanesthesia apnea and bradycardia in preterm and ex-preterm infants. We are developing an alternative technique involving insufflation of sevoflurane and present our initial experience. ⋯ Sedation by insufflation of sevoflurane in small infants is a simple and practical alternative technique for painless imaging such as MRI; further experience is necessary to determine its limitations.
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Paediatric anaesthesia · Jan 2005
Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane.
The purpose of the present study was to show that sevoflurane is a safe and effective agent for the sedation of newborns and infants who are to undergo magnetic resonance imaging (MRI) examinations. ⋯ Sevoflurane is an ideal agent for this type of diagnostic procedure in newborns and infants. We discuss the need for elaborating specific protocols for pediatric sedation and emphasize the strict observation of recommendations, which include the practical experience and up-to-date specialized training of the anesthesiologist carrying out sedation procedures in children.