Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2008
Case ReportsParaplegia after thoracotomy under combined general and epidural anesthesia in a child.
A 9-year-old boy underwent a thoracotomy for excision of his right third rib under combined general and epidural anesthesia for a Ewings sarcoma. Postoperatively, he was found to have a complete T2-3 paraplegia. Permanent paraplegia was described as a rare complication of thoracotomy in adults, and very rarely after epidural analgesia in adults and babies. This was the first report in a child.
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Paediatric anaesthesia · Jun 2008
Intraoperative gastric tonometric examinations in children and infants with a new probe, combined with measurement of the endtidal PCO2.
Important progress relating to the early prediction of postoperative complications was recently achieved through the combined use of endtidal PCO(2) (P(ET)CO(2)) and gastric tonometry. The aim of this article was to present results obtained with a new tonometric instrument, proving its feasibility and extending its use to the control of anesthetized infants and children. ⋯ The tested new probe worked very well in small children. The clinical implications of the large gaps found between P(ET)CO(2) and P(g)CO(2) values in acutely ill children and children undergoing elective operations must be investigated further.
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Paediatric anaesthesia · Jun 2008
Case ReportsProlonged sevoflurane inhalation therapy for status asthmaticus in an infant.
A 3-month-old boy with retractive breathing from his birth was scheduled for a rigid bronchoscopic examination. Anesthesia was induced and maintained with sevoflurane. The examination revealed a slight laryngomalacia which was not compatible with his severe symptom. ⋯ There have been very few reports on application of sevoflurane inhalation for such a long period in infants with bronchospasm. Moreover, measured serum fluoride concentration (24.2 micromol x l(-1)) during inhalation was well below harmful level. Sevoflurane inhalation is worth attempting and safe to treat life-threatening bronchospasm even in infants.
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Paediatric anaesthesia · Jun 2008
A national survey of propofol infusion use by paediatric anaesthetists in Great Britain and Ireland.
Since the introduction of propofol in 1977, it has been widely used for the induction and maintenance of anaesthesia and for sedation on the intensive care unit. Recently, case reports of suspected propofol infusion syndrome (PRIS) following short term infusions have been published. We set out to obtain a picture of the current use of propofol infusions by paediatric anaesthetists in Great Britain and Ireland. ⋯ There is a wide variety in the use of propofol infusions by paediatric anaesthetists. The mechanisms underlying PRIS are poorly understood and require further work to ensure propofol infusions are used appropriately for anaesthesia in children.
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Paediatric anaesthesia · Jun 2008
Perioperative thromboprophylaxis in children: development of a guideline for management.
Venous thromboembolic (VTE) events can occur in children at the time of surgery where a patient has associated prothrombotic risk factors. There is currently little advice available to anesthetists on how to assess the risks and provide prophylaxis. ⋯ Children with multiple risk factors for VTE should be considered for prophylactic measures when presenting for prolonged major surgery.