Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialAnticholinergic prophylaxis does not prevent emesis following strabismus surgery in children.
One hundred and twenty-one children were studied in this prospective, randomized double-blind, placebo-controlled comparison of the effectiveness of anticholinergic prophylaxis for the prevention of emetic symptoms following strabismus surgery. The children were allocated to three groups, to receive placebo (n = 40), glycopyrrolate (n = 40) or atropine (n = 41). ⋯ Thirty percent (12/40) of patients in the placebo group, 25% (10/40) in the glycopyrrolate group, and 22% (9/41) in the atropine group experienced nausea and/or vomiting (difference not significant). It is concluded that prophylactic administration of anticholinergic agents during strabismus surgery in children despite being effective against the occurrence of the oculocardiac reflex, does not reduce the incidence of emetic symptoms.
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Paediatric anaesthesia · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialCaudal analgesia with buprenorphine for postoperative pain relief in children.
Caudal buprenorphine was investigated as a postoperative analgesic in a randomized double blind study in thirty children aged 5-12 years undergoing lower abdominal and lower limb surgery. Comparison was made between two groups of patients, one group receiving plain bupivacaine and the other a combination of plain bupivacaine with buprenorphine. Postoperative analgesia was assessed using a linear analogue scale, and by the response to direct questioning of children using an illustration of sequence of faces. ⋯ The degree and duration of analgesia was far superior in the buprenorphine group and there was a highly significant difference in the requirement of postoperative analgesia between the two groups. There were no major adverse side effects and no motor weakness in either groups, however the incidence of nausea and vomiting was higher in the buprenorphine group. It is concluded that a combination of bupivacaine with buprenorphine administered through the caudal epidural space is a safe and reliable means of providing postoperative pain relief in children for up to 24 h.
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Paediatric anaesthesia · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative morphine requirements, nausea and vomiting following anaesthesia for tonsillectomy. Comparison of intravenous morphine and non-opioid analgesic techniques.
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to be as effective as opioid analgesia following tonsillectomy in children. Opioids are still frequently used but tonsillectomy is associated with a high incidence of vomiting. This study has attempted to assess postoperative analgesic consumption and nausea and vomiting after general anaesthesia for tonsillectomy using either paracetamol premedication, paracetamol plus a NSAID or intravenous morphine to provide postoperative analgesia. ⋯ Postoperative nausea and vomiting was significantly less in the two groups which were not given intraoperative morphine. The number of vomiting incidents was also much less. We conclude that the preoperative administration of paracetamol alone provides satisfactory analgesia in many children but that supplementary analgesia is still required for some.
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Paediatric anaesthesia · Jan 1995
Case Reports Multicenter StudyAccidents following extradural analgesia in children. The results of a retrospective study.
A retrospective multicentre study of the complications observed after regional anaesthesia in children was undertaken in 1991 at the request of the association of Anesthésistes-Réanimateurs Pédiatriques d'Expression Française (ADARPEF). The incidence of accidents seen in the study was comparable to that found in the literature. Five cases which were exceptional due to the severity of the sequelae have been analysed separately. Different pathophysiological mechanisms are proposed.
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Paediatric anaesthesia · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialPropofol reduces the incidence of vomiting after tonsillectomy in children.
We compared the effect of a propofol-based anaesthetic to an isoflurane-based anaesthetic on the incidence of postoperative vomiting in children following tonsillectomy. Thirty-nine children were enrolled in the study and randomized to receive one of the proposed anaesthetics. All patients underwent a mask induction with halothane, nitrous oxide, and oxygen. ⋯ Of 19 patients who received propofol, four vomited (21%); in contrast, of the 20 patients who received isoflurane, 11 vomited (55%). This difference is significant (P = 0.048 two-tailed Fisher's Exact Test). These data suggest that using propofol for anaesthesia can diminish the incidence of vomiting following tonsillectomy.