Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2010
Randomized Controlled TrialIntrathecal clonidine decreases propofol sedation requirements during spinal anesthesia in infants.
Propofol is a popular agent for providing procedural sedation in pediatric population during lumbar puncture and spinal anesthesia. Adjuvants like clonidine and fentanyl are administered intrathecally to prolong the duration of spinal anesthesia and to provide postoperative analgesia. We studied the propofol requirement after intrathecal administration of clonidine or fentanyl in infants undergoing lower abdominal surgeries. ⋯ Our study show that the requirement of propofol sedation reduces with intrathecal adjuvants. The reduction was significant with the addition of clonidine and clonidine-fentanyl combination as opposed to bupivacaine alone or with fentanyl. There was no significant difference in propofol infusion requirement with the use of bupivacaine alone or with fentanyl.
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Paediatric anaesthesia · Jul 2010
ReviewNeuromuscular block and current treatment strategies for its reversal in children.
Even though neuromuscular blocking agents are an essential part of balanced anesthesia and the risks of residual paralysis are well documented, many anesthetists seldomly monitor neuromuscular block. Classical reversal agent neostigmine is unable to antagonise a deep neuromuscular block and is rather slow to antagonise even a moderate block. ⋯ This review presents current views on the effects of muscle relaxants and their reversal agents in pediatric patients. This may help clinicians to reconsider the value of muscle relaxants during anesthesia in children.
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Paediatric anaesthesia · Jul 2010
Comparative StudyComparison of awake spinal with awake caudal anesthesia in preterm and ex-preterm infants for herniotomy.
Spinal anesthesia (SA) is widely used for awake regional anesthesia in ex-preterm infants scheduled for herniotomy. Awake caudal anesthesia (CA) is suggested as an alternative approach for these patients and type of surgery. The aim of this study was to compare efficacy and complications of the two different techniques. ⋯ Caudal anesthesia was shown to be technically less difficult than SA and to have a higher success rate. Its application as awake regional anesthesia technique in these patients seems more appropriate than SA.