Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1999
Case ReportsThe epidural dorsomedian septum as a possible cause for unilateral anaesthesia in an infant.
Unilateral epidural anaesthesia occurring in an infant is reported. An epidurogram revealed the presence of a midline structure suggestive of the dorsomedian septum. Epidural anatomy is reviewed and implications for threading epidural catheters in infants are discussed.
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Paediatric anaesthesia · Jan 1999
Pulmonary atelectasis during paediatric anaesthesia: CT scan evaluation and effect of positive endexpiratory pressure (PEEP).
The case series consisted of ten children, ranged in age from one to three years (median 1.8 yrs), and in body weight from 10.2 to 13.5 kg (median 11.7 kg), in ASA class 1 or 2, all without lung disease. Having undergone general anaesthesia for cranial or abdominal CT scans, the patients were studied for pulmonary morphology. The first pulmonary CT scan was taken five min after induction of general inhalational anaesthesia; preoxygenation was avoided and an intraoperative FiO2=0.4 was used. ⋯ After ventilation with PEEP of 5 cmH2O, all the observed densities disappeared without impairment of heart rate, blood pressure, haemoglobin saturation and endtidal CO2 (PECO2). We conclude that the appearance in children of atelectasis cannot be explained by a reabsorption of O2 mechanism and by denitrogenation. However, a PEEP of 5 cmH2O is able both to recruit all the available alveolar units, and to induce the disappearance of atelectasis in dependent lung regions.
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Paediatric anaesthesia · Jan 1999
Case ReportsCan a dose of 2microg.kg(-1) caudal clonidine cause respiratory depression in neonates?
A case of multiple life-threatening postoperative apnoeas in a term neonate undergoing inguinal herniorrhaphy and orchidopexy who received light inhalation anaesthesia combined with caudal block with 1 ml.kg-1 ropivacaine 0.2% plus 2 microg.kg-1 clonidine is reported. The patient showed no apparent risk factors for postanaesthetic apnoea. Oxycardiorespirography five days after surgery only showed minor abnormalities. Clonidine though administered caudally in the usual dose of 2 microg.kg-1 appeared to be the most likely cause for postanaesthetic apnoea in this neonate.