Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2003
Randomized Controlled Trial Clinical TrialCerebral blood flow velocity in children anaesthetized with desflurane.
Desflurane allows for rapid emergence and changes in depth of anaesthesia which makes it especially suitable for neuroanaesthesia. This study was designed to determine the effects of different desflurane concentrations on cerebral blood flow velocity (CBFV) in healthy children. ⋯ Desflurane in concentrations of 1.0 and 1.5 MAC in children increases CBFV significantly when compared with 0.5 MAC. These changes were associated with a significant increase in HR and decrease in MAP.
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Paediatric anaesthesia · Jul 2003
Randomized Controlled Trial Comparative Study Clinical TrialPerioperative anxiety and postoperative behavioural disturbances in children undergoing intravenous or inhalation induction of anaesthesia.
There are few published data comparing the psychological effects of intravenous (i.v.) and inhalation methods of anaesthesia induction in children. In the present study, we compared perioperative anxiety and postoperative behavioural changes in children undergoing standardized i.v. induction with thiopental and inhalation induction with sevoflurane for routine ear, nose and throat surgery. ⋯ Although children were more anxious during i.v. induction than inhalation induction, there was no difference in the incidence of behavioural disturbances in the first 2 weeks postoperatively.
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Paediatric anaesthesia · Jul 2003
Case ReportsThe management of a postdural puncture headache in a child.
We present a case of an 11-year old girl who underwent an elective pyeloplasty and had an epidural catheter placed for per- and postoperative analgesia. Postoperatively she developed a postural headache and severe nausea, and a diagnosis of postdural puncture headache (PDPH) was made. ⋯ An epidural blood patch was performed with immediate and complete resolution of her symptoms. We present this case to highlight the occurrence of PDPH in children and to outline the considerations for management.
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Paediatric anaesthesia · Jul 2003
Case ReportsThe prolonged use of the laryngeal mask airway in a neonate with airway obstruction and Treacher Collins syndrome.
Upper airway obstruction and difficult tracheal intubation are often encountered in patients with Treacher Collins syndrome (mandibulofacial dysostosis). In this case report, the use of a laryngeal mask airway (LMATM) in a 10-day-old newborn with severe Treacher Collins syndrome and acute airway obstruction is described. ⋯ The difficult decisions with respect to the management of the airway and specifically the role of the laryngeal mask are described. In our opinion, in some newborns with severe mandibulofacial disorders and upper airway obstruction, where conservative airway management procedures have failed, the laryngeal mask can be considered not only to relieve the obstruction but also to buy time until there is full insight into the medical condition and its consequences.
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Paediatric anaesthesia · Jul 2003
Case ReportsPosition dependent ventricular tachycardia in two children with peripherally inserted central catheters (PICCs).
We report two cases of ventricular tachycardia (VT) in children following the insertion of peripherally inserted central catheters (PICCs). These children had additional procedures requiring turning into the left lateral position after PICC insertion. In both cases sustained VT occurred after turning and flexion of the arm with the PICC. VT was terminated in both cases by withdrawing the catheter.