Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2002
Randomized Controlled Trial Clinical TrialThe addition of antiemetics to the morphine solution in patient controlled analgesia syringes used by children after an appendicectomy does not reduce the incidence of postoperative nausea and vomiting.
We studied the effect of intraoperative ondansetron 0.1 mg x kg(-1) or droperidol 0.01 mg.kg-1, followed by the same dose of the antiemetic agent added to the morphine solution during patient controlled analgesia (PCA) on the incidence of nausea and vomiting in children following an appendicectomy. ⋯ We were unable to show any significant benefit from the prophylactic administration of ondansetron or droperidol to children using morphine PCA devices following appendicectomy in the doses we employed.
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A case of unexpected difficult laryngoscopy in a patient with gross hydrocephalus and generalized hypertonus is described. The 30-month-old girl had no antecedent history of such difficulty, having had two recent uneventful anaesthetics. We suggest that the reason for our inability to open the patient's mouth was a result of contracture of the temporalis muscle. The patient was managed using a laryngeal mask airway with controlled ventilation.
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Paediatric anaesthesia · Sep 2002
Is there a role of a small dose of propofol in the treatment of laryngeal spasm?
Propofol has been found to depress the laryngeal reflexes. We studied whether this property could be utilized to relieve laryngeal spasm. ⋯ Propofol in a small dose (0.8 mg.kg-1 body weight) was a useful drug to relieve laryngeal spasm in most children (76.9%) following the removal of the LMA. Because it was not found to be effective in all patients, succinylcholine still has a role to play in critical conditions. However, we recommend propofol as a suitable alternative for relieving laryngeal spasm in situations where succinylcholine is contraindicated.