Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2006
Optimally fitted tracheal tubes decrease the probability of postextubation adverse events in children undergoing general anesthesia.
The air leak test is recommended for assessing the appropriate size of an uncuffed tracheal tube (TT) in children. Our objectives were to determine whether there is a certain threshold air leak value beyond which a higher risk for adverse events after removal of TT can be predicted and to define other risk factors related to extubation. ⋯ Adverse events after removal of TT were more likely to occur in children with an absent air leak at 25 cmH(2)O pressure and in children whose anesthesia was provided by a less experienced anesthetist.
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Paediatric anaesthesia · Jun 2006
Randomized Controlled Trial Comparative StudyTramadol vs morphine during adenotonsillectomy for obstructive sleep apnea in children.
Optimal analgesia for children undergoing adenotonsillectomy for obstructive sleep apnea (OSA) is controversial. Tramadol may represent a superior choice over morphine in this group, with a potential to cause less postoperative sedation and respiratory depression. Optimal perioperative analgesia may allow expensive and time-consuming preoperative work-up and postoperative monitoring to be rationalized. ⋯ Tramadol may be a suitable drug for children undergoing adenotonsillectomy for OSA. Further work is required to investigate this.
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Paediatric anaesthesia · Jun 2006
Case ReportsAnesthesia in a child with fibrodysplasia ossificans progressiva.
We describe the anesthesia management of a 12-year-old girl, diagnosed with fibrodysplasia ossificans progressiva (FOP), who presented with a submandibular abscess. FOP is a rare, inherited disorder with heterotopic bone formation and progressive musculoskeletal disability. This disability ultimately confines patients to a wheelchair. ⋯ This spread along the mandibular margin and under the tongue. She presented with an impending airway compromise in an already difficult situation. The options for airway management in a child with limited mouth opening are discussed.
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Paediatric anaesthesia · Jun 2006
The safety and effectiveness of a modified convection heating system for children during anesthesia.
Convection heating shows most promise in maintaining children's core temperatures under anesthesia. We have previously shown that a modified convection heating technique worked in a mannequin model and sought to establish its safety and effectiveness in a clinical study. ⋯ The technique is safe and effective for children throughout the pediatric range. The practice of increasing room temperature above 21 degrees C for elective cases should be abandoned. Continuous monitoring of core temperature is necessary to prevent hyperthermia.