Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2012
Biography Historical ArticleHistorical vignette: Dr Charles Robson; pioneer Canadian pediatric anesthetist.
Charles Robson (Figure 1) was born in New Westminster, British Columbia (now a suburb of Vancouver), in 1884 and graduated in medicine from McGill University in Montreal in 1913. Having interned and with some anesthesia training at the Royal Victoria Hospital in Montreal, he was sent overseas to work in a Canadian Army Hospital where he founded a school to train military anesthetists. Returning to Canada in 1919, he joined the staff of the Hospital for Sick Children in Toronto as chief anesthetist, a position he held until 1951 (1). During most of this time, he was the sole full-time anesthetist at the hospital; administration of anesthesia at this hospital was not limited to staff anesthetists until 1950 (1).
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Paediatric anaesthesia · Mar 2012
Are children with Angelman syndrome at high risk for anesthetic complications?
To review seven children with Angelman syndrome (AS) undergoing 16 general anesthetics for both invasive and noninvasive procedures to determine if these children are at greater risk for anesthetic-related complications than the general population. ⋯ We found no data to suggest that these patients demonstrate exaggerated responses to GABA stimulating drugs. In fact, it appears that regardless of the anesthetic agent, the perioperative course was unremarkable.
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Paediatric anaesthesia · Mar 2012
Postoperative analgesia via transversus abdominis plane (TAP) catheter for small weight children-our initial experience.
Pain management in small infants and children is challenging. We report the use of unilateral transversus abdominis plane (TAP) catheters for analgesia following single-sided open lower abdominal surgery when epidural analgesia was undesirable in a series of six low-weight children. ⋯ No complications were reported related to these catheters. TAP catheters, although technically challenging, are feasible for the provision of analgesia for surgeries involving the lower abdominal wall in very small patients.
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Morphine is widely used throughout the human life span. Several pharmacokinetic models have been proposed to predict how morphine clearance changes with weight and age. This study uses a large external data set to evaluate the ability of pharmacokinetic models to predict morphine doses. ⋯ Clearance based on empirical allometric scaling predicted unacceptable doses. Theory-based allometric scaling combined with a maturation function has been confirmed by external evaluation to provide a sound basis for describing clearance and predicting morphine doses in humans of all ages.