Paediatric anaesthesia
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Paediatric anaesthesia · May 2001
Clinical TrialPostoperative epidural analgesia with bupivacaine and fentanyl: hourly pain assessment in 348 paediatric cases.
The objective of this prospective study was the evaluation of the analgesia provided by an epidural infusion of bupivacaine and fentanyl after different types of surgery in children. ⋯ This combination of bupivacaine-fentanyl provides safe analgesia after major surgery in children with frequent clinical monitoring. Regular pain assessments of intensity and duration are useful to improve the quality of postoperative analgesia.
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Paediatric anaesthesia · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative nausea and vomiting in paediatric ambulatory surgery: sevoflurane versus spinal anaesthesia with propofol sedation.
Descriptive data report a very low rate of postoperative nausea and vomiting (PONV) following spinal anaesthesia in children. In an attempt to corroborate this observation, we designed a prospective randomized study to compare spinal anaesthesia with intravenous propofol sedation (SA) (n=21) to inhalational sevoflurane anaesthesia (IA) (n=19) with regard to PONV and postoperative analgesia in children (aged 3-12 years) undergoing ambulatory inguinal surgery. ⋯ Despite the reduced number of emetic episodes and the better immediate postoperative analgesia associated with spinal anaesthesia, no difference could be identified between the two different anaesthetic protocols regarding time to discharge or overall patient satisfaction. Thus, despite minor advantages associated with spinal anaesthesia with propofol sedation, both anaesthetic regimen appear equally suitable for use in the paediatric outpatient setting.
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Paediatric anaesthesia · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialPropofol/remifentanil versus propofol alone for bone marrow aspiration in paediatric haemato-oncological patients.
This prospective randomized study was designed to evaluate the effects of adding remifentanil to the standard propofol-based technique in the setting of paediatric haematology-oncology outpatient clinic. ⋯ The addition of remifentanil improved the conditions during the procedure and reduced the total amount of propofol, as well as the time to home readiness. However, the addition of remifentanil is associated with an increased risk of respiratory depression.
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Paediatric anaesthesia · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of four methods for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA) in paediatric patients.
This study compares four tests for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA). We tested the hypothesis that the oropharyngeal leak pressure and interobserver reliability differs between tests. ⋯ We conclude that all four tests provide accurate and reliable information about oropharyngeal leak pressure in children.
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Paediatric anaesthesia · May 2001
Postal survey of cuffed or uncuffed tracheal tubes used for paediatric tracheal intubation.
A postal survey of the use of cuffed or uncuffed tracheal tubes for tracheal intubation in children and infants was performed to investigate the criteria used for deciding the choice of tube and the manner of inflating the cuff in the case of use of a cuffed tracheal tube (CTT). From 200 questionnaires despatched, replies were received from 130 paediatric anaesthesiologists (response rate 65%). In paediatric practice, the CTT was routinely used by 25% of respondents for more than 80% of their patients, while more than 37% of respondents use them in less than 20% of the cases. ⋯ These criteria were specified, respectively, by 32%, 24% and 18% of the respondents. The cuff was inflated in response to a leak in 18% of the cases and as a response to a pressure manometer in 15% of the cases. Few paediatric anaesthesiologists use a cuffed tracheal tube routinely for tracheal intubation in children, and fewer actually use a pressure monitoring device, while it is suggested that the cuff pressure should be monitored in case of CTT.