Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2008
Comparative StudyReversal of rocuronium-induced neuromuscular blockade by pyridostigmine in patients with Duchenne muscular dystrophy.
The aim of this study was to investigate the effect and safety of pyridostigmine for the reversal of a neuromuscular block (NMB) in patients with Duchenne muscular dystrophy (DMD). In patients with DMD recovery from a rocuronium-induced NMB is markedly delayed. ⋯ Pyridostigmine 0.1 mg.kg(-1) effectively reversed a rocuronium-induced NMB in DMD patients.
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Paediatric anaesthesia · Mar 2008
Case ReportsTumor lysis associated with dexamethasone use in a child with leukemia.
Postoperative nausea and vomiting (PONV) occurs in every third patient undergoing general anesthesia without PONV prophylaxis. Antiemetic prophylaxis with dexamethasone is commonly used in patients at moderate risk. We present a case in which PONV prophylaxis with a single dose of dexamethasone led to tumor lysis in a patient with acute leukemia. In case of a cancer patient at moderate risk for PONV, the anesthesiologist should contact the oncologist first, or use other antiemetic drugs such as antiserotoninergic agents for PONV prophylaxis.
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Paediatric anaesthesia · Mar 2008
Comparative StudyIncidence of postdural puncture headache and backache following diagnostic/therapeutic lumbar puncture using a 22G cutting spinal needle, and after introduction of a 25G pencil point spinal needle.
Postdural puncture headache (PDPH) after lumbar puncture (LP) is as common in children as adults. 22G needles are routinely used in adults and children for diagnostic/therapeutic LP, in contrast to 25G or less as standard for spinal anesthesia. We sought to identify incidence of PDPH and backache in oncology children undergoing LP at Royal Marsden Hospital, and whether this could be reduced by a change from 22G to 25G pencil point needle. ⋯ We have confirmed a significant incidence of PDPH in oncology patients and suggest that a 25G pencil point needle can be used successfully for diagnostic/therapeutic LP, with significantly reduced incidence of back pain, and a small tendency towards a shorter duration of PDPH symptoms.
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Paediatric anaesthesia · Mar 2008
Intravenous clonidine infusion in infants after cardiovascular surgery.
The aim of this study was to investigate the hemodynamic profile and heart rhythm in infants who were given intravenous clonidine infusion after prolonged analgesia/sedation following cardiac surgery. ⋯ Although off-label, it is feasible to use clonidine infusions in infants in the PICU setting after cardiac surgery without hemodynamic problems arising.