Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1995
Preoperative evaluation of the cervical spine in children with trisomy-21: results of a questionnaire study.
Atlantoaxial subluxation (AAS) is a form of cervical spine instability predominantly found in persons with Trisomy-21. Several case reports describe the occurrence of acute AAS in the perioperative period. Some authors have recommended cervical spine radiographs prior to elective surgery in all children with Trisomy-21. ⋯ Approximately half of the respondents would attempt to maintain the head and neck in a neutral position for either asymptomatic (42%) or symptomatic (55%) patients. We conclude that the majority of respondents base their preoperative evaluation of the cervical spine on the signs and symptoms of the patient. This is supported by the literature reviewed, but is contrary to the recommendations made in some case reports.
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Paediatric anaesthesia · Jan 1995
Case ReportsOrotracheal intubation through the laryngeal mask airway in paediatric patients with Treacher-Collins syndrome.
The laryngeal mask airway (LMA) is useful as an airway intubator (conduit) for an intubating tracheal bougie or fibreoptic bronchoscope, over which a tracheal tube is passed. However, in our paediatric patients with Treacher-Collins syndrome, only the latter technique was successful. ⋯ Downward displacement of the epiglottis, which can sometimes impair the intubation technique through the LMA, was not observed in our patients. Partial obstruction of a tracheal tube within the LMA occurred in one of the patients.
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Paediatric anaesthesia · Jan 1995
Case ReportsAnaesthetic management of the child with myotonic dystrophy: epidural anaesthesia as an alternative to general anaesthesia.
An 11-year-old boy with myotonic dystrophy required anaesthesia for a lower extremity orthopaedic procedure. The management of patients with myotonic dystrophy is discussed including the use of epidural anaesthesia with a continuous chloroprocaine infusion as an alternative to general anaesthesia.