Paediatric anaesthesia
-
Paediatric anaesthesia · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effects of clonidine and ketamine added to ropivacaine on stress hormone levels and the duration of caudal analgesia.
The purpose of this study was to compare the analgesic quality and duration of ropivacaine 0.2% with the addition of clonidine (1 microg.kg(-1)) with that of ropivacaine 0.2% and the addition of ketamine (0.5 mg.kg(-1)) to that of ropivacaine 0.2% and also compare the postoperative cortisol, insulin and glucose concentrations, sampled after induction and 1 h later following caudal administration in children. ⋯ Addition of ketamine and clonidine to ropivacaine 0.2% 0.75 ml.kg(-1), when administered caudally in children, prolongs the duration of postoperative analgesia. The need for subsequent postoperative analgesic is also reduced. Caudal analgesia attenuates or allows partial changes to postoperative cortisol, insulin or blood glucose responses to surgery.
-
Paediatric anaesthesia · Jul 2005
Randomized Controlled Trial Clinical TrialClonidine administered as adjuvant for bupivacaine in ilioinguinal-iliohypogastric nerve block does not prolong postoperative analgesia.
Coadministration of clonidine with local anesthetics is associated with improvement of the quality of peripheral nerve block and significant prolongation of postoperative analgesia. Better analgesia has been reported with clonidine in ilioinguinal nerve block compared with caudal use. The object of this study was to determine whether adding of 1 microg.kg(-1) clonidine to bupivacaine 0.25% in ilioinguinal-iliohypogastric nerve block prolongs postoperative analgesia in children. ⋯ Our study failed to demonstrate any advantage in addition of 1 microg.kg(-1) clonidine to 0.25% bupivacaine for ilioinguinal-iliohypogastric nerve block compared with bupivacaine 0.25% alone.
-
Paediatric anaesthesia · Jul 2005
Case ReportsDelayed onset refractory dystonic movements following propofol anesthesia.
Neuroexcitation is an uncommon but well recognized side effect of propofol anesthesia and sedation. We present a patient who, despite an intact mental status and without any preexisting movement disorder, experienced delayed onset of involuntary dystonic movements involving head, neck and shoulder for 11 h following emergence from propofol/nitrous oxide anesthesia.
-
Paediatric anaesthesia · Jul 2005
A survey of the use of capnography for the confirmation of correct placement of tracheal tubes in pediatric intensive care units in the UK.
The Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland recommend the use of capnography to ensure correct tracheal tube placement in the theater environment. Correct tracheal tube placement is essential in the care of ventilated patient, even more vital if the patient is critically ill, if serious morbidity and mortality is to be avoided. This survey examined the availability and use of capnography to confirm correct tracheal tube placement in the pediatric intensive care unit (PICU) in the UK. ⋯ The use of capnography to confirm tracheal tube placement may be even more important in the PICU than in adult ICU.
-
Paediatric anaesthesia · Jul 2005
Case ReportsPerioperative management of a child with severe hypertension from a catecholamine secreting neuroblastoma.
Increased catecholamine secretion from neuroblastomas can occasionally be demonstrated, but severe hypertension is uncommon. We report the perioperative management of a 5 year old child with stage III adrenal neuroblastoma who presented with malignant hypertension and high norepinephrine and dopamine levels. Hypertensive crises occurred during anesthesia for surgical biopsy and during chemotherapy. After blood pressure control using phenoxybenzamine and enalapril, doxazosin was used successfully as the preoperative alpha-adrenergic receptor antagonist for surgical tumor resection.