Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2006
Review Case ReportsAnesthesia and Prader-Willi syndrome: preliminary experience with regional anesthesia.
The constellation of neonatal hypotonia, developmental delay, hypogonadism and obesity caused by hyperphagia was first reported in 1956 and subsequently termed Prader-Willi syndrome (PWS). Genetic analysis has demonstrated abnormalities of chromosome 15. ⋯ A lumbar plexus catheter was used to provide postoperative analgesia in one patient while regional anesthesia (fasica iliaca block, spinal anesthesia, and lateral vertical infraclavicular block) was used to provide primary intraoperative anesthesia in three other patients while avoiding the need for general anesthesia. Previous reports of the anesthesia care of patients with PWS are reviewed and the potential perioperative implications of the sequelae of PWS are discussed.
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Advances in electroencephalogram (EEG) processing have produced new interest in measuring anesthesia using the EEG. There are a number of EEG-based anesthesia 'depth' monitors now available and their use in pediatric anesthesia is increasing. Although these monitors have been extensively studied in adults, there are relatively few studies examining their validity or use in children. ⋯ Although the outputs from these monitors do not closely represent any true physiological entity, they can be used as guides for anesthesia and in so doing have improved outcomes in adults. In older children the physiology, anatomy and clinical observations indicate the performance of the monitors may be similar to that in adults, although the clinical relevance of outcomes may be different. In infants their use cannot yet be supported in theory or in practice.
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Paediatric anaesthesia · Aug 2005
Review Case ReportsAcute psychosis after anesthesia: the case for antibiomania.
We report the case of a teenager who developed a postanesthesia acute psychosis (delusions, paranoia, and hallucinations) caused by a reaction to antibiotic therapy (amoxicillin and clarithromycin), so called 'Hoigne's syndrome' or 'antibiomania.' The differential diagnosis and a review of literature are presented. Our patient illustrates the importance of adding antibiomania as part of the differential diagnosis when altered postanesthesia behavior is observed in pediatric patients.