Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2006
Randomized Controlled Trial Comparative StudyPerception of pain following rectal administration of morphine in children: a comparison of a gel and a solution.
Rectal administration of morphine is one possible route of delivery in children. The aim of this study was to determine the pain experience during rectal administration of two different morphine preparations. ⋯ The results indicate that most of the children tolerated rectal administration of morphine well in terms of pain experience, in both gel and solution form. The morphine gel, intended for rectal use appears to be the preparation of choice in children aged 1-6 years.
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Paediatric anaesthesia · Feb 2006
Randomized Controlled Trial Comparative StudyComparison of cuffed, uncuffed tracheal tubes and laryngeal mask airways in low flow pressure controlled ventilation in children.
The use of low flow circle systems necessitates a 'leak free' breathing system which is commonly achieved by using a cuffed tracheal tube (TT). We hypothesized that low flow circle system anesthesia can equally effectively be achieved by using the LMA in pediatric anesthesia. ⋯ We conclude that pressure controlled ventilation using an LMA is an alternative to a cuffed TT during low flow circle system anesthesia in children. Low FGF is unlikely to be achieved consistently using an uncuffed TT because of a substantial leak.
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Paediatric anaesthesia · Feb 2006
Case ReportsThe postoperative cardiovascular arrest of a 5-year-old male: an initial presentation of Duchenne's muscular dystrophy.
Anesthesia may be administered to patients with Duchenne's muscular dystrophy, but cases are reported in which apparently healthy children suffer hyperkalemic cardiac arrest. We present the case of a 5-year-old boy whose muscular dystrophy was discovered following a fatal, perioperative cardiac arrest in the postanesthesia care unit.
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Paediatric anaesthesia · Feb 2006
Comparative Study Clinical TrialComparison of 'whoosh' and modified 'swoosh' test for identification of the caudal epidural space in children.
Caudal analgesia is widely used in pediatric anesthesia practice. The 'whoosh' test which uses air to identify the epidural space, has been recommended as a guide for successful needle placement. However, the use of air may be associated with an incidence of neurological complications. The 'swoosh' test avoids the injection of air and was originally performed using injection of a local anesthetic solution. A comparison was made between the 'whoosh' test and a modified 'swoosh' test using saline to identify the caudal epidural space in children. ⋯ The modified 'swoosh' test is as reliable as the 'whoosh' test and we recommend it for identification of the caudal epidural space in children as it avoids injection of air into the caudal space.
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Paediatric anaesthesia · Feb 2006
Comparative StudyPostoperative morphine consumption in children with sickle-cell disease.
Effective pain control is a primary goal in the perioperative management of patients with sickle-cell disease. To understand analgesic requirements better, the authors compared postoperative morphine consumption and pain scores in sickle and non-sickle children who had undergone laparoscopic cholecystectomy. ⋯ Sickle children self-administered more than double the amount of morphine, reported more intense pain, and remained hospitalized for more than twice as long as nonsickle children undergoing the same surgical procedure. These findings probably have a multifactorial origin, and might be attributable in part to alterations in pain perception, opioid pharmacokinetics, opioid tolerance, and psychosocial variables.