Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2007
Case ReportsAnesthesia for repair of gastroschisis in thoracopagus twins: a case report.
The first pair of live conjoined twins in Fiji were delivered in June 2004. Their union was unexpected and in addition they had gastroschisis requiring urgent surgery. With limited resources available there was uncertainty about the degree of sharing of the major organs. ⋯ Surgical repair of the abdominal defect was performed using a combined general and regional anesthesia technique. The thoracopagus twins died 3 days postoperatively in the Neonatal Intensive Care Unit. Perioperative management is discussed.
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Paediatric anaesthesia · Mar 2007
Ambulatory anesthesia and the lack of consensus among Canadian pediatric anesthesiologists: a survey.
The purpose of this study was to assess the current selection criteria for outpatient surgery in children among Canadian pediatric anesthesiologists. ⋯ Further studies are needed to establish evidence-based medicine to support guidelines that would allow one to select children safely for ambulatory surgery.
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Paediatric anaesthesia · Mar 2007
The relationship between bispectral index and endtidal concentration of sevoflurane during anesthesia and recovery in spontaneously ventilating children.
Global inverse correlation between BIS (bispectral index) and depth of anesthesia using sevoflurane has been documented in children in several studies under experimental conditions and in steady-state conditions during mechanically controlled ventilation. Because sevoflurane mask anesthesia combined with a peripheral nerve block is widely used in children, we studied the relationship between BIS and endtidal concentration of sevoflurane (PE(sevo)) under these conditions during surgery and emergence. ⋯ Caution is required for intraoperative titration based on BIS when spontaneous ventilation is maintained because of the wide variability compared with PE(sevo). During emergence using FAW, BIS varied significantly less than PE(sevo), but the clinical relevance of this point could be discussed during anesthesia without tracheal intubation.
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Paediatric anaesthesia · Mar 2007
RSI in pediatric anesthesia - is it used by nonpediatric anesthetists? A survey from south-west England.
Rapid sequence induction (RSI) is the 'gold standard' technique for preventing aspiration of gastric contents during induction of anesthesia in unfasted patients. We conducted a survey to discover whether the conduct of RSI in children varies amongst anesthetists and if practice alters in relation to the time since training or degree of ongoing experience. ⋯ Classical RSI is used for children by most anesthetists in south-west England. RSI is modified for infants especially by more recently trained consultants. Suxamethonium is used less by consultant anesthetists. Whilst RSI is performed for appendicectomy there is a large variation in techniques for anesthetizing children for MUA and scrotal exploration which is independent of the grade of anesthetist.