Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2004
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia for adenotonsillectomy in children: a comparison of morphine, ketamine and tramadol.
Establishment of good analgesia is of major concern in the postoperative period following adenotonsillectomy. The aim of this study was to compare the effects of ketamine, morphine and tramadol on postoperative pain after adenotonsillectomy in children. ⋯ Morphine hydrochloride 0.1 mg x kg(-1) i.v. administered during induction of anaesthesia provides efficient pain relief in children undergoing adenotonsillectomy.
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Paediatric anaesthesia · Jul 2004
Randomized Controlled Trial Comparative Study Clinical TrialPentobarbital vs chloral hydrate for sedation of children undergoing MRI: efficacy and recovery characteristics.
Chloral hydrate (CH) sedation for magnetic resonance imaging (MRI) is associated with significant failure rates, adverse events and delayed recovery. Pentobarbital (PB), reportedly produces successful sedation in 98% of children undergoing diagnostic imaging. This study compared the efficacy, adverse events and recovery characteristics of CH vs PB in children undergoing MRI. ⋯ Although PB facilitated a quicker sedation onset and reduced the requirement for supplemental sedation, it produced a higher incidence of paradoxical reaction and prolonged recovery with a similar failure rate compared with CH.
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Paediatric anaesthesia · Jul 2004
Multicenter StudyAn evaluation of brainstem death documentation: the importance of full documentation.
With the introduction of the concept of brainstem death as acceptable proof that life has ended, rather than cessation of the beating heart, the process of determining brain death has to be rigorous to ensure maintenance of confidence in the definition. A recent study from South Thames in the UK revealed that only 44% of brainstem death documentation was complete at the time of referral to the transplant coordinator. The aim of our study was to see whether our documentation of brainstem death in paediatric practice complied with the UK Royal College's guidelines and to determine whether any changes are required to be instituted. ⋯ Documentation of adherence to the Royal Colleges, guidelines on brainstem death testing improved significantly between the two study periods as a consequence of major changes in practice within the PICU. With the appointment of dedicated intensive care consultants, care became largely consultant intensivist led and emphasis was placed on the documentation and completion of a single validated brainstem death proforma. It is essential to improve and maintain the quality of brainstem death test documentation in order to ensure the integrity of the process.
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Paediatric anaesthesia · Jul 2004
Comparative StudyAnaesthesia induction in children: a psychological evaluation of the efficiency of parents' presence.
The induction of anaesthesia for surgery is a stressful time for both child and parents. To treat preoperative anxiety in children, pharmacological methods (premedication) and behavioural methods (the presence of parents during the induction of anaesthesia) have been used, both independently and in combination. The purpose of this investigation was to study the effect of both premedication and parental presence on preoperative anxiety in a homogeneous population. ⋯ Maternal presence, compared with the father's presence, is fundamental in helping to overcome anxiety in a child receiving anaesthesia. If the parents are present during the induction, the addition of premedication does not offer further benefit. Parents themselves judged their presence during the induction of anaesthesia in their child as a positive event. We also found a statistical significant correlation between anxiety of the parents with the level of the stress of the child during induction of anaesthesia.