Paediatric anaesthesia
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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
Postoperative pain in children: a survey of parents' expectations and perceptions of their children's experiences.
Parental expectation and participation in postoperative analgesia is very important in paediatric practice. In order to improve postoperative pain management in children, the parents of 31 elective surgical children, three months to 15 years of age, were asked preoperatively about their expectations regarding their children's postoperative pain and pain relief. At 24 h after surgery, the parents were asked about their perceptions of their children's pain and pain control. ⋯ Nine (29%) of the children experienced severe or unbearable pain or experienced pain for the whole of the 24 h after surgery. An approach to improve pain management in children could be for the hospital staff to reorganize and to develop an 'acute pain service'. A pain service may not require new technology, but instead be based on more effective communication and skill in utilizing the traditional systems.
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Paediatric anaesthesia · Jan 1996
Oxygen enrichment of entrained room air during Venturi jet ventilation of children undergoing bronchoscopy.
Intermittent oxygen jet ventilation at an inspiratory:expiratory ratio of 1:3 was used to ventilate 15 children undergoing rigid Storz bronchoscopy for removal of inhaled foreign body. Oxygenation of the patient was continuously monitored by pulse oximetry. In all children SpO2 was above 95% when the bronchoscope was above the carina. ⋯ Oxygen jet ventilation during bronchoscopy is based on the Venturi principle; the oxygen jet will entrain room air from the side arm of the bronchoscope which functions as an entrainment orifice. This will decrease the FIO2. The FIO2 can be increased by flowing oxygen continuously via the T-piece attached to the side arm of the bronchoscope.