Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2008
Randomized Controlled Trial Comparative StudyUltrasound-guided supraclavicular vs infraclavicular brachial plexus blocks in children.
Supraclavicular brachial plexus blocks are not common in children because of risk of pneumothorax. However, infraclavicular brachial plexus blocks have been described in paediatric patients both with nerve stimulation and ultrasound (US)-guidance. US-guidance reduces the risk of complications in supraclavicular brachial plexus blocks in adults. ⋯ (i) Ultrasound-guided supraclavicular and infraclavicular brachial plexus blocks are effective in children. (ii) There has been no pneumothorax in 40 US-guided supraclavicular brachial plexus blocks performed by anaesthesiologists already trained in US-guided regional anaesthesia using an IP technique in children > or =5 years old. (iii) In this study, the supraclavicular approach of the brachial plexus was faster to perform than the infraclavicular one.
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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
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.
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Paediatric anaesthesia · Sep 2008
Sizes and depths of endotracheal tubes for cleft lip and palate children undergoing primary cheiloplasty and palatoplasty.
Appropriate sizes (internal diameters) and insertion depths of uncuffed preformed endotracheal tubes in children with cleft lip and palate, who generally have delayed growth and development in early infancy have not been elucidated. ⋯ The current findings suggest that it is reasonable to apply the currently available standards for normal children, e.g. Motoyama's general guide, to predict the tube size and insertion depth for Japanese cleft lip and palate children, and that the use of the uncuffed preformed endotracheal tube is associated with a risk of endobronchial intubation, which appears to increase with age.