Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2005
Utility of ultrasound-guided central venous cannulation in pediatric surgical patients: a clinical series.
Central venous cannulation can be particularly difficult in pediatric patients. Central line placement is associated with many well-known complications. While ultrasound-guided techniques are well established, the majority of central venous catheters are placed using landmark guidance. This retrospective study compares the safety and efficacy of ultrasound guidance vs landmark guidance in central venous cannulation of pediatric cardiac surgery patients. ⋯ The overall success of internal jugular vein cannulation for pediatric cardiac surgery is significantly improved with the use of ultrasound guidance, without a significant difference in traumatic complications. However, mostly children above 1 year of age or 10 kg of weight experience advantages of ultrasound technique.
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Paediatric anaesthesia · Nov 2005
Case ReportsAcute pancreatitis induced by short-term propofol administration.
The incidence of a drug-induced pancreatitis is rare and so far more than 85 different drugs have been reported to have induced pancreatitis. Some case reports consider a relationship between propofol and acute pancreatitis. However, in these cases a number of different drugs were coadministered, thus preventing a clear causal link being established. ⋯ She developed pancreatitis within hours after exposure to propofol. Other possible triggers, e.g. gallstones or infection were ruled out. Physicians should consider pancreatitis as a potentially life-threatening adverse event associated with propofol sedation, which is nowadays extensively used.
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Paediatric anaesthesia · Nov 2005
Case ReportsSubmental intubation for cancrum oris: a case report.
Cancrum oris (Noma) is a devastating gangrenous disease that leads to severe tissue destruction in the face. We describe the anesthetic management of a 12-year-old girl with cancrum oris sequelae in a Rural Secondary level Hospital in Central India (Padhar Hospital). She presented with a large defect in her upper lip on the left side that extended into the columella and the floor of the left nostril. ⋯ She made a satisfactory recovery and the submental scar healed without complication or scarring. We describe briefly the features of cancrum oris and review the technique of submental intubation (described in adults with midfacial trauma). The use of submental intubation in children and for cancrum oris sequelae has not been previously reported.
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Paediatric anaesthesia · Nov 2005
Cardiac tamponade associated with a peripheral vein central venous catheter.
We present a case of cardiac tamponade associated with placement of a central venous catheter (CVC) via a peripheral vein in a 14-year-old girl with idiopathic scoliosis undergoing corrective surgery. A number of complications have been described in association with CVC misplacement. Sporadic cases of cardiac tamponade from this have been reported, but the actual incidence is unknown. ⋯ The main diagnostic test for this condition is echocardiography and the only effective treatment is drainage of the pericardial effusion. Echocardiography should be performed before pericardiocentesis except in life-threatening situations or high clinical suspicion. Although they are rare, it is important to be aware of the potential for CVC complications.