Paediatric anaesthesia
-
Paediatric anaesthesia · Dec 2004
Comparative Study Clinical TrialS-ketamine and s-norketamine plasma concentrations after nasal and i.v. administration in anesthetized children.
It has been suggested that nasal administration of s-ketamine may be used to improve sedation or premedication in combination with nasal midazolam in pediatric patients. In this study we measured and compared plasma concentrations of s-ketamine and its main metabolite s-norketamine after nasal and i.v. administration in preschool children. ⋯ Nasal administration of s-ketamine 2 mg x kg(-1) results in a wide spread of plasma concentrations and absorption times. Rapid and high level drug absorption after nasal drug administration is possible. The use of a pulse oximeter and continuous observation after nasal administration of s-ketamine for pediatric premedication is recommended.
-
Paediatric anaesthesia · Dec 2004
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialOral clonidine does not change ventilatory response to carbon dioxide in sevoflurane-anesthetized children.
Clonidine is a useful premedicant for pediatric anesthesia. The drug has potential for ventilatory depression. The aim of the current study was to determine the effects of clonidine premedication on the ventilatory response to hypercapnia during sevoflurane anesthesia using the carbon dioxide (CO(2)) steady state method. ⋯ These data suggest that oral clonidine is a suitable premedication for sevoflurane anesthesia under spontaneous breathing conditions in children.
-
Paediatric anaesthesia · Dec 2004
Sonographic imaging of the sciatic nerve and its division in the popliteal fossa in children.
High resolution ultrasound is a possible option for anesthetists to detect nerves. We tested the possibility of imaging the sciatic nerve and its division into the tibial and peroneal part using high resolution ultrasound in children. ⋯ Ultrasound opens a window to detect the anatomy of the sciatic nerve in children. In addition, the surrounding anatomical structures can also be depicted. The results suggest a possibility of safe placement of a cannula for blockade of the sciatic nerve under visual control.
-
A 2 year-old boy presented with acute upper airway obstruction following a 15-month history of noisy breathing and hoarseness. An urgent laryngotracheal bronchoscopy was performed following inhalational induction of anesthesia. ⋯ Twelve days later, the tracheostomy was successfully decannulated with the child's voice beginning to normalize. The family remembered the decoration from Christmas celebrations 2 years prior and recalled a coughing episode that predated the onset of hoarseness.
-
Paediatric anaesthesia · Dec 2004
Clinical signs of infection during continuous postoperative epidural analgesia in children: the value of catheter tip culture.
Infection arising from the use of epidural catheters for postoperative analgesia is a major source of anxiety. ⋯ Minor local signs of inflammation and infection are common in pediatric patients during continuous epidural infusion. Epidural catheter tips are also frequently culture positive in patients with and without local signs and who may not go on to develop further signs or symptoms of infection. Routine culture of catheter tips is unnecessary as it is not a good predictor of epidural space infection.