Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2001
Impact of an antiemetic protocol on postoperative nausea and vomiting in children.
The objective of the study was to demonstrate a decreased incidence of postoperative nausea and vomiting (PONV) in children through the use of an antiemetic protocol. PONV was recorded in children (1.5-15 years) after inpatient surgery under general anaesthesia in a prospective, interview based survey. Group 1 consisted of children having surgery 1 month before the introduction of a formalized antiemetic protocol and group 2, 2 months after its introduction. ⋯ Patient satisfaction was high in both groups (85% versus 90%). The introduction of a postoperative antiemetic protocol improved prescribing frequency. This resulted in a decreased incidence of moderate to severe PON and a reduction in the number of patients with repeated nausea.
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Paediatric anaesthesia · Jan 2001
Evaluation of caudal anaesthesia performed in conscious ex-premature infants for inguinal herniotomies.
Ex-premature infants, before 45 weeks postconceptional age, are at high-risk of apnoea after surgery. General anaesthesia increases the risk of apnoea. We evaluated the tolerance and the efficiency of caudal anaesthesia performed in 25 consecutive conscious ex-premature infants for inguinal herniotomies. ⋯ The principal advantage of the procedure is to facilitate and simplify the postoperative management of the babies. The anaesthetic technique does not alter surgical conditions. Caudal epidural anaesthesia performed in awake high-risk preterm infants is beneficial for these infants but requires experienced operators.
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Paediatric anaesthesia · Jan 2001
Case ReportsA technique for maintenance of airway access in infants with a difficult airway following tracheal extubation.
Tracheal extubation of patients with a difficult airway represents a challenge to anaesthesiologists and intensive care physicians. While a variety of techniques designed to maintain access to the airway in case of the need for tracheal reintubation have been described in adults, no reports have been published in infants and young children. We describe an approach to this issue in a young child with severe micrognathia.
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There are no reports of the parental perceptions of comfort during the mechanical ventilation of children. We have assessed the quality of sedation in 28 mechanically ventilated children and compared these results to an overall parental assessment of comfort, obtained by postal questionnaire. ⋯ Parents appear to become more satisfied with the degree of comfort of their children as the duration of mechanical ventilation increases, which is an effect that may have an important bearing on communication between parents and health professionals. Our results also suggest that the commonly used sedation regime of midazolam and morphine is less effective in younger children.