Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2005
Randomized Controlled Trial Comparative StudyAddition of clonidine and fentanyl: comparison between three different regional anesthetic techniques in circumcision.
Several techniques have been used for alleviating post-circumcision pain with regional anesthetics being more effective than systemic opioids. Our aim was to compare the effectiveness of dorsal penile block, ring block (RB) and dorsal penile block associated with RB in reducing post-circumcision pain in children. ⋯ Dorsal penile block plus RB technique is superior to dorsal penile block alone and RB alone in reducing postcircumcision pain in children.
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Paediatric anaesthesia · Nov 2005
Randomized Controlled Trial Comparative StudyComparison of morphine and tramadol by patient-controlled analgesia for postoperative analgesia after tonsillectomy in children.
Tramadol is an alternative to other opioids for postoperative pain management. This prospective, randomized, double-blind study was designed to compare the analgesic efficacy of patient-controlled tramadol with patient-controlled morphine for postoperative pain after tonsillectomy in children. ⋯ Intravenous patient-controlled tramadol is an alternative to patient-controlled morphine for postoperative pain relief in children after tonsillectomy. Morphine gave better postoperative pain relief, but was associated with a higher incidence of nausea than tramadol.
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Paediatric anaesthesia · Nov 2005
Can continuous low current electrical stimulation distinguish insulated needle position in the epidural and intrathecal spaces in pediatric patients?
Muscle twitches elicited with electrical stimulation (6-17 mA) during epidural insertion indicate correct epidural needle placement while muscle twitches at a lower current (<1 mA) may indicate intrathecal needle placement. This study examined whether applying continuous electrical stimulation at 6 mA could indicate needle entry into the epidural space without inadvertently penetrating the intrathecal space. ⋯ Monitoring with an insulated needle with electrical stimulation at 6 mA may prevent unintentional placement of epidural needles into the intrathecal space.
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Paediatric anaesthesia · Nov 2005
Case ReportsEarly complication of pediatric central venous cannulation.
We describe a case of hemothorax following central venous catheter (CVC) insertion in an infant. Presumably injury occurred as a result of perforation with the dilator. Strategies to reduce the risk of complications and possible factors influencing the unsatisfactory delay in diagnosis, including the role of 'Fixation Error', are discussed.
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Paediatric anaesthesia · Nov 2005
Caudal injectate can be reliably imaged using portable ultrasound--a preliminary study.
Correct caudal cannula placement is essential for block success and the avoidance of complications. The aim of this study was to assess the use of a saline injection test bolus with ultrasound (US) imaging to identify correct cannula placement for caudal anesthesia. ⋯ These preliminary results suggest saline test bolus under US imaging is a reliable indicator of correct cannula position for caudal block. We found it safe, quick to perform, and provided additional useful information.