Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2007
Initial experience with dexmedetomidine for diagnostic and interventional cardiac catheterization in children.
Children undergoing diagnostic and interventional cardiac catheterization require deep sedation or general anesthesia (GA). Dexmedetomidine, a selective alpha-2 adrenergic agonist, has sedative, analgesic and anxiolytic properties without respiratory depression. These characteristics make it potentially suitable as a sedative agent during diagnostic procedures in children. We report our experience using dexmedetomidine in 20 children aged 3 months to 10 years undergoing cardiac catheterization. ⋯ This initial experience showed dexmedetomidine, with or without the addition of propofol, may be a suitable alternative for sedation in spontaneously breathing patients undergoing cardiac catheterization.
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Paediatric anaesthesia · Feb 2007
Case ReportsAnesthesia management of a patient with a laryngotracheo-esophageal cleft.
Laryngotracheo-esophageal cleft is a rare congenital anomaly that results from complete or partial failure of the development of the tracheoesophageal septum. The presenting symptoms include stridor, respiratory distress, and coughing or cyanotic episodes with feeding. There are four classifications for laryngeal clefts; the severity depends on the type present. We discuss the anesthesia management of a neonate with a Type IV cleft who presented for an emergency gastric division to prevent pulmonary aspiration and later returned for final repair of the defect.
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Paediatric anaesthesia · Feb 2007
Case ReportsMinor increase of endtidal CO2 during sevoflurane-induced malignant hyperthermia.
Malignant hyperthermia (MH) in a pediatric patient during sevoflurane anesthesia with only a minor rise of endtidal CO(2) is described. MH was considered because of increased rectal temperature. ⋯ In vitro contracture tests were performed on muscle biopsies from both parents. A strong contracture in response to halothane confirmed the father's MH susceptibility, thereby according a high probability of an MH episode in his son.
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Paediatric anaesthesia · Feb 2007
Case ReportsResolution of pulmonary interstitial emphysema following selective left main stem intubation in a premature newborn: an old procedure revisited.
Pulmonary interstitial emphysema (PIE) contributes to worsening respiratory status in already compromised premature infants. Various treatments for PIE include high-frequency ventilation, postural therapy, pneumonectomy or lobectomy and selective bronchial intubation. ⋯ In this case report, we revisit this procedure and describe successful treatment of right lung PIE with hyperinflation by selective left main stem intubation at 2 weeks of life in a 24-week-old premature infant who had respiratory distress syndrome and pulmonary hemorrhage. A detailed description is given to allow clinical bedside replication following specific anatomic landmarks.
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Paediatric anaesthesia · Feb 2007
Letter Case ReportsAnesthesia for congenital insensitivity to pain with anhidrosis.