Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2010
Randomized Controlled TrialThe effects of caudal or intravenous clonidine on postoperative analgesia produced by caudal levobupivacaine in children.
Clonidine is used increasingly in pediatric anesthesia practice to prolong the duration of action of caudal block with a local anesthetic agent. Which route of administration of clonidine is the most beneficial remains unknown. We compared the effects of caudal and intravenous clonidine on postoperative analgesia produced by caudal levobupivacaine. ⋯ Caudal clonidine prolongs the duration of analgesia produced by caudal levobupivacaine without causing significant side effects and this is because of a spinal mode of action.
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Paediatric anaesthesia · Apr 2010
Randomized Controlled TrialDoes the newer preparation of propofol, an emulsion of medium/long chain triglycerides cause less injection pain in children when premixed with lignocaine?
Injection pain during propofol administration can be particularly distressing in children. The newly available emulsion of propofol in medium and long chain triglycerides (LCT) is reported to cause less injection pain because of lower concentrations of free propofol. This study compared the incidence of injection pain during administration of propofol emulsion of LCT and propofol emulsion of medium and long chain triglycerides (MCT/LCT) both premixed with lignocaine in children. ⋯ Propofol MCT/LCT and propofol LCT premixed with lignocaine are both associated with pain on injection in children; the incidence and intensity of the injection pain are similar.
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Paediatric anaesthesia · Apr 2010
Randomized Controlled TrialEfficacy of two oral premedicants: midazolam or a low-dose combination of midazolam-ketamine for reducing stress during intravenous cannulation in children undergoing CT imaging.
Pain, anxiety and fear of needles make intravenous cannulation extremely difficult in children. We assessed the efficacy and safety of oral midazolam and a low-dose combination of midazolam and ketamine to reduce the stress and anxiety during intravenous cannulation in children undergoing computed tomography (CT) imaging when compared to placebo. ⋯ A low-dose combination of oral midazolam and ketamine or oral midazolam alone effectively reduces the stress during intravenous cannulation in children undergoing CT imaging without any adverse effects. However, the combination provides more children in calm and quiet state when compared to midazolam alone at venipuncture.
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Paediatric anaesthesia · Apr 2010
ReviewAnesthetic considerations for the pediatric oncology patient--part 1: a review of antitumor therapy.
The anesthesiologist who cares for children with cancer or for survivors of childhood cancer should possess a basic understanding of cancer treatment. While this is an ever-changing field, a basic knowledge of chemotherapeutic drugs, radiation therapy, and the toxicities of each is necessary to prepare a safe anesthetic plan. ⋯ This article, which is the first of a three-part review series, will review current principles of cancer therapy and the general mechanisms of toxicity to the child. Although this article is not intended to comprehensively review the fundamentals of chemotherapy and radiation therapy, the consequences of anticancer therapy that impact perioperative care and decision making are presented for the anesthesiologist.
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Paediatric anaesthesia · Apr 2010
An allometric model to estimate fluid requirements in children following burn injury.
To evaluate the ability of an allometric 3/4 Power Model combined with the Galveston Formula (Galveston-3/4 PM Formula) to predict fluid resuscitation requirements in children suffering burn injuries in comparison with the frequently used Parkland Formula and Galveston Formula using the Du Bois formula for surface area estimation (Galveston-DB Formula). ⋯ For the purposes of clinical estimation of fluid requirements, the Galveston-3/4 PM Formula is indistinguishable from the Galveston-DB Formula in children 23 kg or less.