Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1998
The effect of circuit compliance on delivered ventilation with use of an adult circle system for time cycled volume controlled ventilation using an infant lung model.
This in vitro study examined the effect of circuit compliance on delivered ventilation (VE) using a time-cycled, volume controlled circle system in an infant lung model. A Bio-Tek ventilator tester set to simulate normal and abnormal lung compliance measured VE delivered by the Narkomed 2B system. Circle circuits of varied compliance (2.75, 1.22 and 0.73 microliters.cm H2O-1) were tested. ⋯ TT size had minimal effects on VE when lung compliance was low; TT size was a more important factor when test lung compliance was normal. Extrapolating this data to the clinical setting, adequate ventilation of infants can be achieved with an adult circle system if an appropriate PIP is chosen, regardless of the compliance of the circuit used. Infants with poor lung compliance may require very high PIP for adequate ventilation.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Comparative Study Clinical TrialComparison of granisetron and droperidol in the prevention of vomiting after strabismus surgery or tonsillectomy in children.
This prospective, randomized, double-blinded study evaluated the antiemetic efficacy of granisetron and droperidol in 80 ASA physical status I children, aged 4-10 years, undergoing strabismus surgery or tonsillectomy with or without adenoidectomy. After anaesthetic induction, the patients received either granisetron (40 micrograms.kg-1, n = 40) or droperidol (50 micrograms.kg-1, n = 40) intravenously. ⋯ The requirement for rescue antiemetic therapy for the treatment of two or more episodes of vomiting was 0% with granisetron and 18% with droperidol (P = 0.001). In conclusion, granisetron was superior to droperidol in reducing the incidence and frequency of postoperative vomiting in paediatric patients.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of intramuscular tenoxicam with intramuscular morphine for pain relief following tonsillectomy in children.
A double blind trial was conducted to evaluate the analgesic efficacy of intramuscular tenoxicam for pain relief following tonsillectomy in children. Fifty children, aged 3-10 years, were randomly allocated to receive intramuscular tenoxicam 0.75 mg.kg-1 or intramuscular morphine sulphate 0.2 mg.kg-1 after induction of anaesthesia. ⋯ There was no difference between the quality of analgesia after discharge from recovery. The incidence of postoperative vomiting was significantly reduced after tenoxicam (20%) compared with morphine (71%).
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of intubation success for paediatric transport team paramedics using lighted vs regular tracheal tube stylets.
We conducted a prospective randomized study of success rate and time to intubation using Trachlight and Surch-Lite lighted stylets versus a regular tracheal tube stylet, in a training setting. Participants, 18 paediatric transport paramedics, performed two intubations with each of the three devices, using an airway management trainer. There was no significant difference in mean time for intubation between the three devices. ⋯ External confirmation of the tube placement using the lighted stylets was quicker than laryngoscopic visualization. In darkness, with a nonfunctioning laryngoscope, intubations were successfully performed 100% of the time with the lighted stylet, but only 11% of the time with the regular stylet. All paramedics felt that a lighted stylet would be a useful airway management adjunct for the transport environment for complicated intubations or for use in very high or low levels of ambient light.
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Paediatric anaesthesia · Jan 1998
Comparative Study Clinical TrialSafety and efficacy of semi-closed circle ventilation in small infants.
The purpose of this clinical trial was to investigate the safety and efficacy of semi-closed circle ventilation of the Dräger anaesthesia ventilators (Cicero, Cato), using a fresh gas flow (FGF) of 600 ml.min-1. Twenty infants, weighing less than 6000 g, without cardiorespiratory abnormalities who required general anaesthesia of at least 30 min were included. The FGF was reduced to 600 ml.min-1 after 10 min of denitrogenation with a FGF of 4 to 61.min-1. ⋯ Hypoxic gas concentrations were not observed. Neither nitrogen nor CO2 accumulated in the circle system. In conclusion, low flow anaesthesia can be performed safely in infants under 6000 grams with the Dräger Cicero and Cato anaesthesia ventilators.