Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2002
Management of postdural puncture headache with epidural blood patch in children.
Until the last decade, it was believed that postdural puncture headache (PDPH) was an uncommon complaint in children, but recent studies indicate that young children may develop PDPH after spinal puncture. When the symptoms are severe and are not relieved within a few days with analgesics, forced hydration and bed rest, then epidural blood patch (EBP) might be performed. ⋯ EBP gave some relief of symptoms in all children. No complications related to EBP were noticed.
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Paediatric anaesthesia · Jul 2002
Case ReportsSevere epiglottic prolapse and the obscured larynx at intubation.
Laryngomalacia is the most common congenital anomaly of the larynx and usually involves prolapse of the arytenoids, so-called 'posterior laryngomalacia'. Most cases resolve with growth of the child and maturation of the larynx, although, rarely, significant airway obstruction can be present. Severe laryngomalacia preventing intubation is rarely encountered. ⋯ The child was referred with a diagnosis of laryngeal atresia on the basis of the intubating laryngoscopic view of no apparent epiglottis or laryngeal inlet. The child was transferred with a tube in the oesophagus that kept the child oxygenated. At the time, oxygenation was felt to be due to a coexisting tracheo-oesophageal fistula, although this was eventually found not to be the case.
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Paediatric anaesthesia · Jun 2002
Emergence behaviour in children: defining the incidence of excitement and agitation following anaesthesia.
Children display a variety of behaviour during anaesthetic recovery. The purpose of this study was to study the frequency and duration of emergence behaviour in children following anaesthesia and the factors that alter the incidence of various emergence behaviour following anaesthesia. ⋯ Repeated assessments of behaviour following anaesthetic recovery are required to define an incidence and duration of emergence agitation. Emergence agitation occurs most frequently in the initial 10 min of recovery, but many children who arrive asleep experience agitation later during recovery.
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Paediatric anaesthesia · Jun 2002
Thoracic epidural catheters placed by the caudal route in infants: the importance of radiographic confirmation.
Cephalad advancement of epidural catheters to the thoracic region via the caudal route has been shown to be feasible in neonates and small infants. This has allowed many young infants to receive thoracic level epidural analgesia with dilute local anaesthetic solutions using the simpler caudal approach. Since radiographic confirmation of the catheter tip is routine at this institution, we wished to determine how often radiographic studies led to adjustment or replacement of the epidural catheter. ⋯ Even in young infants, radiographic determination of the catheter tip appears warranted when thoracic catheters are placed via the caudal route.