Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1999
Review Comparative StudyThe use of propofol infusions in paediatric anaesthesia: a practical guide.
Children require higher infusion rates of propofol than adults to maintain clinical anaesthesia. We aimed to produce a manual infusion regimen capable of maintaining a steady-state blood concentration of 3 microg ml(-1) in children aged 3-11 years. Pharmacokinetic parameter estimates were taken from published studies of infusion data in children and used in a pharmacokinetic simulation programme to predict likely propofol blood concentrations during infusions. ⋯ The context sensitive half-time in children was longer than in adults, rising from 10.4 min at 1 h to 19.6 min at 4 h compared to adult estimates of 6.7 min and 9.5 min, respectively. Children require higher infusion rates than adults to maintain steady state concentrations of 3 microg x ml(-1) and have longer context sensitive half-times than adults. These differences can be attributed to altered pharmacokinetics in this age group.
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Paediatric anaesthesia · Jan 1999
Observation of the correlation of postanaesthesia recovery scores with early postoperative hypoxaemia in children.
To observe the correlation of the postanaesthesia recovery score (PARS) with the incidence, and severity of early postoperative hypoxaemia in children, 1213 infants and children, ASA physical status I, aged three months to 14 years, scheduled for elective plastic surgery were included in this study. Arterial oxygen saturation (Spo2) levels were recorded while children were breathing room air shortly after arrival in the recovery room (0 min), and 5, 10, 15, 20, 30, 40, 50, 60, 120 and 180 min thereafter. The PARS was also determined on all patients when Spo2 levels were recorded in the recovery room. ⋯ There were significant differences among the three groups. Of the 91 children who required O2 supplementation in the recovery room because of low measured Spo2, 69 had the PARS of < or = 6, and 22 had the PARS of 7-8. It is concluded that if a patient has a PARS of 10, the patient will not need routine oxygen supplement because hypoxaemia will not occur.