Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2003
Case ReportsPostobstructive pulmonary oedema during anaesthesia in children with mucopolysaccharidoses.
We present case reports of five patients with severe forms of mucopolysaccharidoses who developed postobstructive pulmonary oedema during anaesthesia. The difficulties of anaesthesia in these patients and the particular predisposition that these patients exhibit for the development of postobstructive pulmonary oedema is discussed.
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Paediatric anaesthesia · May 2003
Randomized Controlled Trial Comparative Study Clinical TrialA randomized trial of caudal block with bupivacaine 4 mg x kg-1 (1.8 ml x kg-1) plus morphine (150 microg x kg-1) vs general anaesthesia with fentanyl for cardiac surgery.
Regional anaesthesia has been used effectively in paediatric patients undergoing cardiac surgery and is thought to be safe. ⋯ Caudal block with bupivacaine 0.22% 4 mg.kg-1 (1.8 ml.kg-1) and morphine 150 microg x kg-1 was safe and effective for paediatric patients undergoing cardiac surgery. However, patients might have a better outcome with a reduction of morphine dosage and administration of a muscle relaxant of shorter duration of action than pancuronium.
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Paediatric anaesthesia · May 2003
Randomized Controlled Trial Clinical TrialIncreased incidence of postoperative nausea and vomiting without additional analgesic effects when a low dose of intravenous fentanyl is combined with a caudal block.
The use of opioids is known to increase the incidence of postoperative nausea and vomiting (PONV). In spite of this, administration of low doses of an opioid during anaesthesia is common practice, even if a regional anaesthetic technique is used. This study was designed to estimate the effects of intraoperative intravenous administration of fentanyl on PONV in paediatric daycase surgery. ⋯ Intraoperative use of i.v. fentanyl 1 micro g.kg-1 combined with a regional anaesthetic block is associated with an increased incidence of PONV without any significant contribution to the postoperative pain relief.