Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialClonidine-mepivacaine mixture vs plain mepivacaine in paediatric surgery.
In a double-blind study, 42 children, aged 1-10, undergoing general subumbilical surgery, were randomly allocated to two groups; they received, via caudal extradural, 1% mepivacaine 7 mg.kg-1 and normal saline 1 ml (Group 1) and a mixture of 1% mepivacaine 7 mg.kg-1 plus clonidine 2 micrograms.kg-1 and normal saline up to 1 ml (Group 2) respectively. No significant difference was noticed in age, weight, duration of surgery and onset time of anaesthesia, blood pressure, heart rate and oxygen saturation. ⋯ This longer sedation is due both to the longer analgesia and partially to a side effect of clonidine. In conclusion the addition of 2 micrograms.kg-1 of clonidine to mepivacaine prolongs the duration of caudal analgesia in children.
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Rett syndrome is a devastatingly disabling neurological disease that is only observed in girls. Scoliosis occurs in roughly half the girls and surgery may be required. ⋯ Sudden death may be a feature of the disease which occurred four weeks postoperatively in one case. Although a long QTc interval may be seen, it did not occur in any of our cases.
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Paediatric anaesthesia · Jan 1996
Patient controlled analgesia (PCA) in paediatric surgery: a prospective study following laparoscopic and open appendicectomy.
Patient controlled analgesia (PCA) has not yet gained universal acceptance for the management of postoperative pain in paediatric surgery. In a prospective study we evaluated feasibility and complications of PCA following 90 cases of laparoscopic or open appendicectomy. ⋯ Assessment of application protocols showed, that the consumption of analgesics was significantly reduced following laparoscopic appendicectomy (P < 0.05). PCA is a safe and feasible method for the management of postoperative pain in children and PCA recording provides an excellent insight into the consumptional behaviour of patients, enabling staff to evaluate postoperative pain for various procedures.
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Paediatric anaesthesia · Jan 1996
The rectus sheath block in paediatric anaesthesia: new indications for an old technique?
The rectus sheath block has been used with success for postoperative analgesia in adults. This paper reviews the anatomy of the rectus sheath, and presents our initial experience of using the block to provide intra- and postoperative analgesia in children having repair of umbilical and paraumbilical hernia. The rectus sheath block appears to be a useful technique in children, particularly for paediatric day-cases surgery.
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Paediatric anaesthesia · Jan 1996
Case ReportsRight bevelled tube for selective left bronchial intubation in a child undergoing right thoracotomy.
Left bronchial intubation was used to achieve selective left lung ventilation in a five-year-old child, undergoing thoracotomy for excision of a hydatid cyst of the right lung. Intubation of the left main stem bronchus was easily achieved from the first attempt by a right bevelled tracheal tube. ⋯ One lung ventilation using 1-2% halothane in 100% oxygen was associated with Spo2 that ranged between 95-97%, and endtidal PETCO2 ranging between 3.9-4.5 kPa (30-35 mmHg). Following excision of the hydatid cyst, the tube was withdrawn above the carina into the trachea, and two lung ventilation was continued until the end of surgery.