Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2007
Relationship between age and spontaneous ventilation during intravenous anesthesia in children.
Maintaining spontaneous ventilation in children, using total intravenous anesthesia (TIVA), is often desirable, particularly for airway endoscopy. The aim of this study was to evaluate the effect of age on the dose of remifentanil tolerated during spontaneous ventilation under anesthesia maintained with infusions of propofol and remifentanil and to provide guidelines for the administration of remifentanil and propofol to maintain spontaneous ventilation in children. ⋯ Younger children, especially those aged less than 3 years, tolerate a higher dose of remifentanil while still maintaining spontaneous respiration. TIVA with spontaneous ventilation is readily achieved in younger children and infants.
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Paediatric anaesthesia · Oct 2007
Changes in respiratory and hemodynamic parameters during low-dose propofol sedation in combination with regional anesthesia for herniorrhaphy and genitourinary surgery in children.
Spontaneous vs mechanical ventilation during propofol sedation has been a subject of debate. We evaluated the safety of low-dose propofol sedation as an adjunct to regional anesthesia during herniorrhaphy and genitourinary surgery in infants and children. ⋯ Low-dose propofol sedation in combination with regional anesthesia for elective herniorrhaphy and genitourinary surgery in children maintains spontaneous ventilation and has minimal effects on hemodynamic parameters for sedation lasting <1 h. The presence of PEEPi is a relative contraindication to the use of this regimen in children with asthma or history of upper airway infections.
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Paediatric anaesthesia · Oct 2007
Case ReportsA rather unconventional use of the laryngeal mask airway.
Jaw masses are often associated with difficult airway and very often anesthesiologists have to use ingenious but safe techniques to secure the airway. This report is upon awake insertion of the laryngeal mask airway in a patient with a huge jaw tumor.
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Paediatric anaesthesia · Oct 2007
Letter Randomized Controlled TrialDexmedetomidine as an analgesic for pediatric tonsillectomy and adenoidectomy.
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Paediatric anaesthesia · Sep 2007
ReviewWhen nitrous oxide is no laughing matter: nitrous oxide and pediatric anesthesia.
Although often felt to be relatively innocuous, nitrous oxide can have significant metabolic effects in settings of abnormal vitamin B12 and B12-related metabolism in children. These conditions can be genetic or environmental. ⋯ Although overt genetic diseases are relatively uncommon, the implications of nitrous oxide interactions with much more frequent but less symptomatically obvious single nucleotide polymorphisms are potentially more concerning. In addition, nitrous oxide can have direct and differing neurotoxic effects on both immature and aged brain, the clinical impact of which remains undetermined.