Paediatric anaesthesia
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We present the case of a nine-year-old boy afflicted with Ondine's curse, who developed complete atrioventricular heart block after a single bolus of propofol for induction of anaesthesia for strabismus surgery. Ondine's curse, the other name for congenital central hypoventilation syndrome, is characterized by a generalized disorder of autonomic function. ⋯ Heart block has been documented after propofol bolus use in adults but, to our knowledge, not in children. It would appear that propofol is not a good choice for anaesthesia in congenital central hypoventilation syndrome.
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Paediatric anaesthesia · Jan 1999
Comparative StudyThe influence of breathing system filters on paediatric capnography.
Breathing system filters are in common use during paediatric anaesthesia. Expired gas sampling from the patient side of these filters may contaminate and saturate the sampling line, while sampling from the machine side may cause underestimation of end-tidal carbon dioxide (PECO 2). ⋯ PECO 2 was higher at the patient side of the filter in both ventilated and spontaneously breathing groups (P<0.002 for each). The bias in measuring at the machine side of the filter was significantly greater in the spontaneously breathing children as compared with the mechanically ventilated children (-1.8 vs -0.7 kPa; P<0.004).
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Paediatric anaesthesia · Jan 1999
Case ReportsA different under vision approach to a difficult intubation.
A simple and safe technique of intubation with minimal discomfort to the patient using a nasopharyngeal airway, fibreoptic bronchoscope and guide wire in a three-year-old is presented.
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Paediatric anaesthesia · Jan 1999
Case ReportsExtrapyramidal side-effects from droperidol mixed with morphine for patient-controlled analgesia in two children.
We report two cases of extrapyramidal reactions occurring in children following the use of droperidol in combination with morphine for patient-controlled analgesia (PCA). Symptoms appeared 38 and 27 h, respectively, after commencement and after a total dose of 0.14 mg.kg-1 and 0.17 mg.kg-1, respectively. Although effective and safe in adult patients, we recommend caution with the use of droperidol-morphine mixtures for PCA in paediatric patients.
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Paediatric anaesthesia · Jan 1999
Case ReportsSome vagaries of neonatal lumbar epidural anaesthesia.
Regional anaesthesia and analgesia offer unique advantages of reduction in general anaesthesia requirements and the demands on NICU resources while improving the general outcome. We assessed the feasibility of continuous lumbar epidural analgesia in 20 neonates for various major surgical procedures lasting from 60-260 min. The babies were aged 18 h to 34 days. ⋯ They were awake but comfortable at the time of extubation. There were no complications due to the technique. Subsequent to this study, epidural analgesia either by lumbar or caudal route has become the routine in our hospital for all major thoraco-abdominal surgical procedures in neonates.