Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialSevoflurane in paediatric anaesthesia: effects on respiration and circulation during induction and recovery.
This study examined induction and recovery times and respiratory and cardiovascular changes during induction and recovery in paediatric patients undergoing anaesthesia under spontaneous respiration induced with sevoflurane (S group, n = 10) and halothane (H group, n = 9) at 2.4 MAC. FET/FI increased more rapidly, the incidence of breath holding and coughing was less and the recovery time was shorter in the S group compared with the H group. ⋯ Slight decrease in blood pressure was observed during induction in the S group, while the circulatory depression was not observed during induction in the H group. These results suggest that sevoflurane is a suitable agent for induction under spontaneous respiration with higher concentrations in paediatric anaesthesia.
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of diclofenac and tenoxicam for postoperative analgesia with and without fentanyl in children undergoing adenotonsillectomy or tonsillectomy.
127 children scheduled for elective tonsillectomy or adenotonsillectomy were studied. Anaesthesia was induced with propofol and maintained with a volatile agent. At induction the child received either rectal diclofenac 1 mg.kg-1 with or without fentanyl 0.75 microgram.kg-1 i.v., or intravenous tenoxicam 0.4 mg.kg-1 with or without fentanyl 0.75 microgram.kg-1 i.v. ⋯ Pain scores in the tenoxicam without fentanyl group were significantly higher in recovery (P < 0.05) than the diclofenac group without fentanyl and both fentanyl groups. This group required supplemental analgesia earlier although this was not significant. The pain scores in the diclofenac with fentanyl group were significantly lower at one h and four h than the group receiving diclofenac alone (P = 0.008 and 0.02 respectively).
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialOral transmucosal ketamine: an effective premedication in children.
The oral cavity offers a simple, painless way of drug administration. For this reason, we used oral transmucosal ketamine (5-6 mg.kg-1) for premedication in 25 children and compared it with intranasal ketamine (5-6 mg.kg-1), placebo and intramuscular ketamine (5-6 mg.kg-1). ⋯ The lollipops produced a slight increase in gastric volumes but did not affect gastric pH. In conclusion OTK has been shown to be an effective, harmless preoperative medication in paediatric patients.
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of 4.5% human albumin solution and Haemaccel in neonates undergoing major surgery.
In a randomized blinded study we compared two colloid solutions in 30 neonates undergoing major surgery. Fifteen neonates received 4.5% Human albumin solution (HAS) (mean volume 25.6 ml.kg-1, SD 9.5) and the others received Haemaccel (Hoechst) (24.9 ml.kg-1, SD 10). Pre and postoperative plasma albumin and haemoglobin concentrations and plasma colloid osmotic pressure (COP) were compared. ⋯ In the HAS group there was no significant change in either the plasma albumin concentration or COP. There was a small but significant decrease in the mean haemoglobin concentration from 15.92 to 14.35 g.dl-1 (mean difference 1.56, CI 0.57 to 2.55) after HAS. We conclude that HAS is the superior colloid for volume replacement in neonates undergoing surgery.
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Clinical TrialCisatracurium during halothane and balanced anaesthesia in children.
Cisatracurium, 51W89, is one of the ten stereoisomers of Tracrium which, unlike atracurium, has been reported to have a lack of histamine mediated cardiovascular effects at doses as high as 8 x ED95 in adults. We compared the time-course of neuromuscular effects of 80 micrograms.kg-1 or 100 micrograms.kg-1 cisatracurium during N2O-O2-halothane or N2O-O2-opioid anaesthesia, respectively, in 32 children 2-12 years old. Neuromuscular function was monitored by evoked adductor pollicis EMG. ⋯ Train-of-four ratio recovered to 0.70 in 2.5 (1.8-3.0) or 3.2 (2.1-4.3) min following neostigmine during halothane or balanced anaesthesia, respectively (NS). Changes in blood pressure or heart rate following cisatracurium were negligible. We regard cisatracurium as a safe and promising intermediate duration muscle relaxant the effects of which can easily be reversed with neostigmine.