Paediatric anaesthesia
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There are few data describing clonidine population pharmacokinetics in children (0-15 years) despite common use. Current pediatric data, described in terms of elimination half-life or C(max) and T(max), poorly explain variability in drug responses among individuals representative of those in whom the drug will be used clinically. ⋯ Clearance in neonates is approximately one-third that described in adults, consistent with immature elimination pathways. Maintenance dosing, which is a function of clearance, should be reduced in neonates and infants when using a target concentration approach.
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Paediatric anaesthesia · Oct 2007
Airway management and anesthesia in neonates, infants and children during endolaryngotracheal surgery.
Endolaryngotracheal surgery in neonates, infants and children poses a big challenge for both anesthesiologist and surgeon. The narrowness of the airways and the great variability of the pathological lesions necessitate close collaboration between the surgical and the anesthesia team to provide optimal operating conditions and ensure adequate ventilation and oxygenation. ⋯ Supraglottic superimposed high-/low-frequency jet ventilation via jet laryngoscopes with integrated jet nozzles is a minimally invasive ventilation technique for neonates, infants and children in endolaryngotracheal surgery, which allows an unimpaired operating field for the surgeon especially in LASER surgery.
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Paediatric anaesthesia · Oct 2007
Case ReportsA rather unconventional use of the laryngeal mask airway.
Jaw masses are often associated with difficult airway and very often anesthesiologists have to use ingenious but safe techniques to secure the airway. This report is upon awake insertion of the laryngeal mask airway in a patient with a huge jaw tumor.
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Paediatric anaesthesia · Oct 2007
Randomized Controlled Trial Comparative StudyPropofol-ketamine vs propofol-fentanyl for sedation during pediatric upper gastrointestinal endoscopy.
The aim of this study was to compare the clinical efficacy and safety of propofol-ketamine with propofol-fentanyl in pediatric patients undergoing diagnostic upper gastrointestinal endoscopy (UGIE). ⋯ Both PK and PF combinations provided effective sedation in pediatric patients undergoing UGIE, but the PK combination resulted in stable hemodynamics and deeper sedation though more side effects.
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Paediatric anaesthesia · Oct 2007
Insertion characteristics, sealing pressure and fiberoptic positioning of CobraPLA in children.
The CobraPLA(TM) is a new supraglottic airway device designed for the use in spontaneously breathing and mechanically ventilated patients. In adults it has been found as effective as the LMA, but with better sealing qualities. The aim of the present study was to evaluate fit and sealing characteristics of CobraPLA size 1.5 and 2 in mechanically ventilated children. ⋯ The CobraPLA was found to have easy insertion characteristics and good anatomical fitting in children between 10 and 35 kg. If positive pressure ventilation with CobraPLA size 1.5 and 2.0 is required, peak inspiratory pressure should be kept below the leak pressure and the abdomen closely monitored for signs of gastric insufflation.