Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2007
Clinical TrialIs a fall in baseline heart rate a reliable predictor of a successful single shot caudal epidural in children?
This study was designed to investigate whether a fall in heart rate (HR) with injection of local anesthetic into the caudal space can be used as a predictor of correct needle placement. ⋯ We conclude that decrease in HR with drug injection is a simple, objective and reliable test to predict success of caudal block.
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Paediatric anaesthesia · Jun 2007
Case ReportsDexmedetomidine as a total intravenous anesthetic in infants.
In this case report, we describe the use of dexmedetomidine as the sole anesthetic for four infants requiring general anesthesia for direct laryngoscopy and bronchoscopy with spontaneous ventilation. Surgical conditions were adequate and the hemodynamic and respiratory profiles of this technique are described.
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Paediatric anaesthesia · Jun 2007
Case ReportsDeep sedation with intravenous infusion of combined propofol and ketamine during dressing changes and whirlpool bath in patients with severe epidermolysis bullosa.
Continuous i.v. infusion of propofol, or propofol plus ketamine for deep sedation and analgesia was carried out in two patients with severe epidermolysis bullosa (EB) during extensive dressing changes and deep whirlpool baths. Intermittent small doses of narcotics were given as supplement for pain relief as needed. Both patients had typical features of severe EB, including extremity contractures, severe digit deformity, difficult airways, extensive blisters and broken skin with denuded areas and severe wound infections. ⋯ Retrospective anesthesia record review showed that the combined propofol and ketamine infusions provided satisfactory sedation with significantly reduced narcotic requirements compared with propofol alone. There were no noticeable side effects when ketamine was added. Ketamine appears to be a good addition to propofol and narcotics to provide sedation and analgesia when there are great concerns for respiration depression, apnea, difficult pain management and potential unstable hemodynamics during dressing changes and whirlpool baths in severe EB patients.
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Paediatric anaesthesia · Jun 2007
Unplanned anesthesia-related admissions to pediatric intensive care - a 6-year audit.
Unplanned admissions to the intensive care unit may result from unexpected events related to anesthesia, and are recommended by some healthcare organizations as a clinical indicator. The rate of anesthesia-related unplanned admissions in adults ranges between 0.04% and 0.45% of procedures. However, there is a paucity of data relating to the rate in children. ⋯ We found the unplanned admission rate to the PICU in our hospital population to be similar to that reported for adults, and is a relatively rare event in pediatric anesthesia. Most admissions were for children aged less than 5 years and were as a result of airway problems. Most cases were deemed potentially predictable.