Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2008
Randomized Controlled Trial Comparative StudyUltrasound-guided supraclavicular vs infraclavicular brachial plexus blocks in children.
Supraclavicular brachial plexus blocks are not common in children because of risk of pneumothorax. However, infraclavicular brachial plexus blocks have been described in paediatric patients both with nerve stimulation and ultrasound (US)-guidance. US-guidance reduces the risk of complications in supraclavicular brachial plexus blocks in adults. ⋯ (i) Ultrasound-guided supraclavicular and infraclavicular brachial plexus blocks are effective in children. (ii) There has been no pneumothorax in 40 US-guided supraclavicular brachial plexus blocks performed by anaesthesiologists already trained in US-guided regional anaesthesia using an IP technique in children > or =5 years old. (iii) In this study, the supraclavicular approach of the brachial plexus was faster to perform than the infraclavicular one.
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Paediatric anaesthesia · Sep 2008
Letter Case ReportsAn unforeseen complication of orotracheal suctioning.
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Paediatric anaesthesia · Sep 2008
Plasma B-type natriuretic peptide monitoring to evaluate cardiovascular function prior to organ procurement in patients with brain death.
The natriuretic peptide system plays an active role in the regulation of fluid balance and systemic vascular resistance. Assays of plasma concentrations of B-type natriuretic peptide (BNP) may have a diagnostic role in evaluating myocardial function. We present our experience with BNP monitoring to assess myocardial function after the proclamation of brain death in potential organ donors. ⋯ Assays of plasma BNP concentrations have been shown to be helpful in differentiating myocardial dysfunction from primary lung disease in both the adult and pediatric population. However, our data demonstrate that mechanisms other than myocardial performance may regulate BNP levels in patients with severe central nervous system injury who progress to brain death. Our preliminary data suggest that these assays appear to be of limited value in assessing myocardial performance in this population.
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Paediatric anaesthesia · Sep 2008
Fasting times in caregivers of children presenting for ambulatory surgery.
It has been the anecdotal experience in this unit that many parents and guardians of children presenting for day-case surgery also fast along with their child for prolonged periods of time. There have been several episodes of parents feeling dizzy or nauseated on leaving the anesthetic room after induction of anesthesia, and many incidents of fainting in recovery when collecting their child. Our purpose was to investigate this theme further, by auditing the fasting times of caregivers coming to the induction room over a 3-month period. This information has not been previously described in the literature. ⋯ A large proportion of parents choose to fast with their children. Some caregivers fast for long periods. In general, this does not cause any ill effects, although some parents missed routine medications while fasting.