Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2008
Randomized Controlled Trial Comparative StudySubhypnotic propofol infusion plus dexamethasone is more effective than dexamethasone alone for the prevention of vomiting in children after tonsillectomy.
Postoperative vomiting (POV) is a common complication after tonsillectomy. Dexamethasone is known to decrease postsurgical vomiting. In this study, we compared the effects of dexamethasone alone to dexamethasone plus propofol on postoperative vomiting in children undergoing tonsillectomy. ⋯ For children undergoing tonsillectomy, intraoperative subhypnotic propofol infusion combined with dexamethasone treatment provides a better prophylaxis against postoperative vomiting than does dexamethasone alone.
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Paediatric anaesthesia · Sep 2008
Comparative StudyLongtime performance and reliability of two different PtcCO2 and SpO2 sensors in neonates.
Blood gas monitoring is necessary in treatment of critically ill neonates. Whereas SaO2 can be estimated by pulse oximetry, PaCO2 is still most often assessed from blood samples. ⋯ The TOSCA monitor allows safe estimation of PtcCO2 and SaO2 in neonates. Measurements of PtcCO2 were less reliable with TOSCA compared with conventional monitoring but still allow assessing a trend of ventilation status in newborn patients.
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Paediatric anaesthesia · Sep 2008
Case ReportsOne hundred times the intended dose of caudal clonidine in three pediatric patients.
We report three sequential cases in which children received 100 times the intended dose of clonidine in their single shot caudals. Although all experienced excessive somnolence for up to 24 h, none had respiratory depression, oxygen desaturation, supplemental oxygen requirement, or hemodynamic instability. These cases suggest a large margin of safety exists for caudally administered clonidine in healthy children.
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Paediatric anaesthesia · Sep 2008
Massage therapy in outpatient pediatric chronic pain patients: do they facilitate significant reductions in levels of distress, pain, tension, discomfort, and mood alterations?
This study was designed to look at the efficacy of adjuvant massage therapy in children and adolescents who presented to a chronic pediatric pain clinic for management. ⋯ After massage therapy, patients reported highly significant improvement in their levels of distress, pain, tension, discomfort, and mood compared with their premassage ratings (all t-values >6.1, ****P < 1 x 10(-8). To control for the possible effects of patients reporting improvements simply as a result of rating their symptoms, we collected control ratings before and after a comparable 'no intervention' time period in a subset of 25 patients. The 'no intervention' time period typically took place in the treatment room with the therapist present. Approximately 60% of the control ratings were obtained before the intervention and 40% were obtained after the massage therapy. None of the differences between the pre- and postratings associated with the 'no intervention' control time period were significant. In these same patients, the difference between the pre- and postmassage ratings were significant, all t-values >3.8, **P < 0.001.
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Paediatric anaesthesia · Sep 2008
Electroencephalographic Narcotrend Index monitoring during procedural sedation and analgesia in children.
The electroencephalographic Narcotrend Index (NI) may potentially help to titrate sedative medication during diagnostic and therapeutic procedures in children. ⋯ The results of this study suggest that the NI may be an objective nondisruptive tool for assessment of hypnotic depth in children under propofol-induced procedural sedation.