Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2013
Randomized Controlled TrialSteal induction in preschool children: is melatonin as good as clonidine? A prospective, randomized study.
To investigate whether melatonin would be an alternative drug to clonidine for performance of steal induction. ⋯ Melatonin was effective for steal induction in 75% of children compared to 88% of children who had clonidine. Melatonin resulted less effective when administered early in the morning.
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Paediatric anaesthesia · Apr 2013
Comparative StudyImpact of rocuronium vs succinylcholine neuromuscular blocking drug choice for laparoscopic pyloromyotomy: is there a difference in time to transport to recovery?
This study evaluates the relationship between neuromuscular blocking drug administered and transport time following laparoscopic pyloromyotomy. ⋯ For laparoscopic pyloromyotomy in term infants using propofol, sevoflurane and no intraoperative opioid, succinylcholine may be the best neuromuscular blocking drug choice, provided no contraindication is present. However, based on the small difference in time to transport, rocuronium as administered herein may be a reasonable alternative preferred by some clinicians.
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Laryngeal cleft is a rare congenital malformation that is being reported with increasing frequency. Diagnosis requires suspension microlaryngoscopy under general anesthesia during spontaneous respiration. Repair may be attempted by a minimally invasive endoscopic approach or open surgical repair. The authors report on their experience with total intravenous anesthesia (TIVA) and spontaneous ventilation without an endotracheal tube during suspension laryngoscopy and CO2 laser application for this specific surgical procedure. Of particular interest were the rate at which this technique failed and rescue techniques were employed and the ability to predict patients in whom this might occur. ⋯ The technique of TIVA with spontaneous respirations without an endotracheal tube is a safe and effective technique for laryngeal cleft repair. Although the potential for intraoperative adverse events may be high, the actual rate was very low. The need to convert to other techniques is not significant although the children who did require brief periods of jet ventilation or intubation tended to have reactive airway disease or chronic lung disease.
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Paediatric anaesthesia · Apr 2013
Randomized Controlled Trial Comparative StudyComparison of the efficacy of ramosetron and ondansetron in the prophylaxis of postoperative vomiting in children receiving fentanyl by patient-controlled analgesia after orthopedic surgery: a randomized controlled trial.
This study was designed to compare the efficacy of prophylactic ramosetron and ondansetron in preventing postoperative vomiting in children who received fentanyl by patient-controlled analgesia after orthopedic surgery. ⋯ Ramosetron was more effective during the first 24-h period after surgery than ondansetron in children using fentanyl patient-controlled analgesia after general anesthesia.
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Paediatric anaesthesia · Apr 2013
The characteristics of the staircase phenomenon during the period of twitch stabilization in infants in TOF mode.
Acceleromyography used to monitor the neuromuscular transmission function is available in infants and children. However, information on the so-called staircase phenomenon during the baseline stabilization period in this population is limited. Our objective was to assess the characteristics of such phenomenon in infants in acceleromyography. ⋯ The staircase effect presents in a shorter time course and at lower degrees in smaller infants. However, in older infants, staircase effect still presents in a long period and may influence the onset time and duration of twitch depression after muscle relaxants administration.