Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2007
Comparative Study Clinical TrialComparative evaluation of Bispectral Index and Narcotrend Index in children below 5 years of age.
The use of electroencephalogram (EEG) monitoring devices for assessing the depth of hypnosis is most difficult in children under 5 years of age. ⋯ The BIS currently seems to be superior to the NI, but age-related processing algorithms of the raw EEG must be implemented in both BIS and NI in order to be useful in children younger than 5 years of age.
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Paediatric anaesthesia · Feb 2007
Comparative Study Clinical TrialAtelectasis in children undergoing either propofol infusion or positive pressure ventilation anesthesia for magnetic resonance imaging.
Atelectasis because of anesthesia is a recognized problem but may be affected by the anesthetic technique. We compared magnetic resonance images of atelectasis in children undergoing two types of anesthesia. ⋯ Many factors may influence the development of atelectasis but this study found less extensive atelectasis with PI than PPV. PI allows for sufficient motionlessness, required for high diagnostic image quality in pediatric MRI.
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Paediatric anaesthesia · Feb 2007
Risk factors for adverse events in children with colds emerging from anesthesia: a logistic regression.
Recent upper respiratory infection (URI) in children increases respiratory adverse events following anesthesia for elective surgery. The increased risk continues weeks after resolution of acute URI symptoms. Few systematic analyses have explored specific risk factors. This logistic regression explores the relationship between preoperative URI symptoms and adverse events during emergence from anesthesia. ⋯ Specific preoperative symptoms were not useful in predicting respiratory adverse events during emergence from anesthesia.
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Paediatric anaesthesia · Feb 2007
Clinical TrialA pilot study of inhaled methoxyflurane for procedural analgesia in children.
Methoxyflurane (MF), a potent volatile anesthetic, can be used as an analgesic in subanesthetic concentrations. In Australia, MF is extensively used in children and adults as an analgesic in the prehospital setting via a hand-held inhaler device. We conducted a pilot study to explore its use as a patient controlled analgesic for painful procedures in children in the emergency department (ED). ⋯ On the basis of this small pilot study of MF use in children in the ED, this agent appears to be a powerful analgesic. MF seems most useful as a self-titrated bridging analgesic agent in patients after extremity trauma. It appears less useful as a procedural agent when patients are unable to anticipate and achieve a sufficient level of analgesia before painful stimulus infliction. Pre- and intraprocedure coaching is an important aspect of its use especially if initial pain scores are low.
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Paediatric anaesthesia · Feb 2007
Clinical TrialRopivacaine spinal anesthesia in neonates: a dose range finding study.
Our primary aim was to determine the minimum local anaesthetic dose (MLAD) defined as the median effective local anesthetic dose for spinal anesthesia in neonates. Secondary aims were to determine the dose-response curve for spinal anesthesia including the clinically relevant ED95 dose and to describe the duration of motor block following ropivacaine spinal anesthesia. ⋯ Ropivacaine is an effective agent for spinal anesthesia in neonates at a recommended dose of 1.08 mg.kg(-1). The motor block duration, however, is significantly shorter than equivalent agents and highly variable in duration.