Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2001
Comparative StudyPostoperative behavioural changes in children: comparison between halothane and sevoflurane.
A questionnaire, modified from the posthospitalization behavioural questionnaire, was sent to all parents of children under 8 years of age who had elective surgery in the hospital of Lahr during the years 1997 and 1998. The parents were asked about long lasting changes (more than 1 week) in their child's behaviour after surgery. ⋯ We found that the children having sevoflurane anaesthesia were more likely to develop behavioural problems postoperatively than with halothane. The rate of postoperative behavioural changes was not influenced by the type of surgery, the sedative premedication used, the induction technique or the use of opioids or nonopioid pain therapy.
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Paediatric anaesthesia · Nov 2001
Randomized Controlled Trial Comparative Study Clinical TrialDownfolding of the epiglottis induced by the laryngeal mask airway in children: a comparison between two insertion techniques.
The purpose of this study was to compare the incidence of the downfolding of the epiglottis in children during insertion of the laryngeal mask airway (LMATM) using the standard technique and an alternative technique with the cuff partially inflated. ⋯ The partially inflated cuff insertion technique does not increase the incidence of the downfolding of the epiglottis in children and would be an acceptable alternative to the standard technique.
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Paediatric anaesthesia · Nov 2001
Randomized Controlled Trial Comparative Study Clinical TrialPressure versus volume-controlled ventilation with a laryngeal mask airway in paediatric patients.
The utility of positive pressure ventilation with the laryngeal mask airway (LMA) in children was described previously, but the possibility of gastric insufflation, related to high peak airway pressure, continues to be a disadvantage. In this prospective study, inspiratory pressures, air leak and signs of gastric insufflation were compared between volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) using an LMA. ⋯ During general anaesthesia in children using an LMA, PCV offers lower peak inspiratory airway pressures while maintaining equal ventilation compared with VCV. Although no signs of gastric insufflation were detected in both groups, the lower pressures might be significant in patients with reduced chest wall or lung compliance.
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Paediatric anaesthesia · Nov 2001
Case ReportsLife threatening cardiopulmonary failure in an infant following protamine reversal of heparin after cardiopulmonary bypass.
Life threatening cardiopulmonary failure following protamine reversal of heparin after cardiopulmonary bypass (CPB) was reported to occur in adults but rarely in children. Atrial septal defect closure was performed in a 6-week-old infant erroneously suspected to suffer from right atrial thrombosis in addition. ⋯ Inhaled nitric oxide, together with high frequency oscillation ventilation supplemented by intravenous prostacycline, enabled complete recovery of cardiopulmonary and neurological function. Life threatening cardiovascular compromise after intravenous protamine can occur even in young infants which then require challenging paediatric critical care.
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Paediatric anaesthesia · Nov 2001
Randomized Controlled Trial Clinical TrialBispectral index monitoring during infant cardiac surgery: relationship of BIS to the stress response and plasma fentanyl levels.
We evaluated the relationship of the bispectral index (BIS) to commonly used indices of depth of anaesthesia in 19 infants enrolled in a prospective study of the stress response to hypothermic cardiopulmonary bypass. ⋯ We were unable to demonstrate a relationship between the BIS and haemodynamic, metabolic or hormonal indices of anaesthetic depth. Further evaluation of the BIS algorithm is required in neonates and infants.