Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1997
Case ReportsAnaesthetic management of children with Joubert syndrome.
We report the anaesthetic management of two children with Joubert syndrome. Children with this syndrome have abnormalities of respiratory control due to changes in the brainstem and cerebellum. They are extremely sensitive to the respiratory depressant effects of anaesthetic agents, including nitrous oxide. Anaesthesia using inhalational induction, controlled ventilation, avoidance of opioids, and close postoperative monitoring is recommended.
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Paediatric anaesthesia · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialAnaesthesia for insertion of ear tubes in children: comparison of propofol, thiopentone and halothane.
To determine the quality of anaesthesia and speed of recovery after propofol anaesthesia for myringotomy in children, 100 children 2-12 years were randomized to one of four anaesthetic regimens for induction/maintenance: thiopentone (STP) (5 mg.kg-1)/halothane, propofol (3 mg.kg-1)/halothane, halothane/halothane or propofol (3 mg.kg-1)/propofol bolus (0.5 mg.kg-1 every 3 min (10 mg.kg-1.h-1)). Nitrous oxide (70%) in oxygen (30%) was used to facilitate insertion of an intravenous catheter and was continued throughout the anaesthetic. ⋯ Although some recovery variables (time to response to questions, sit unaided, tolerate oral fluids, and discharge with fluids) were achieved more rapidly by the prop/ prop group than the other three groups, the times to open eyes, obey commands and, most importantly, discharge from recovery without fluids did not differ between the prop/prop and the hal/ hal groups. We conclude that there is little benefit in using propofol as an induction agent alone or in combination with a propofol maintenance anaesthetic for paediatric myringotomy and tube surgery.
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Paediatric anaesthesia · Jan 1997
Randomized Controlled Trial Clinical TrialIntermittent positive ventilation through a laryngeal mask in children: does it cause gastric dilatation?
After obtaining Ethics Committee approval and informed consent, sixty children, ASA Grade 1 or 2 and aged six months to ten years, were randomly allocated to receive intermittent positive pressure ventilation through either a laryngeal mask or a tracheal tube. Inflation pressures were maintained below 20 cm H2O, and gas aspirated from the stomach via an orogastric tube over a one h period. No large volumes were aspirated and no differences were detected between the groups. We conclude that healthy children over the age of six months can be safely ventilated through the laryngeal mask airway without gastric distension.
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Paediatric anaesthesia · Jan 1997
Randomized Controlled Trial Clinical TrialDiclofenac vs oxybuprocaine eyedrops for analgesia in paediatric strabismus surgery.
Forty children undergoing strabismus surgery as day patients were randomly allocated to receive oxybuprocaine 0.4% eyedrops or 0.1% diclofenac eyedrops for perioperative analgesia. A non-invasive anaesthetic technique using the reinforced laryngeal mask airway was used. The study demonstrated that both topical analgesics provided good to excellent analgesia and the anaesthetic technique was associated with a relatively low incidence of nausea and vomiting. Complications were limited to two children who were admitted with persistent postoperative nausea and vomiting.
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Paediatric anaesthesia · Jan 1997
Case ReportsAnaesthetic management during awake craniotomy in a 12-year-old boy.
We present our approach to the preoperative preparation and anaesthetic management for awake craniotomy in a 12-year-old boy. Management included conscious sedation with a propofol infusion plus local anaesthetic infiltration of the scalp, periosteum, and dura. The complications which may be encountered during such procedures and their treatments are reviewed.