Journal of clinical anesthesia
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Comparative Study Clinical Trial Controlled Clinical Trial
Caudal analgesia for pediatric day case surgery: assessment of motor function prior to discharge.
The benefits of caudal analgesia are well recognized in the prevention of postoperative pain following pediatric surgery. The possibility of motor weakness may deter anesthetists from using this technique. This study investigates motor function prior to discharge in boys who, as day case patients, received caudal analgesia for pain relief following circumcision. ⋯ Three different dosage regimens of bupivacaine were compared. No important motor weakness was demonstrated, and there was no difference with respect to motor block in the three groups. Caudal analgesia may be recommended as a suitable technique for day case patients.
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Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. ⋯ After reintubation of the trachea, frothy pink fluid was discharged from the tube, and chest roentgenogram showed a right-sided alveolar infiltrate. Many factors may cause unilateral pulmonary edema, but it is suggested that acute subglottic edema and unilateral bronchial fragility strongly affected this episode.
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The Grieshaber Air System was designed to maintain intraocular pressure during ophthalmologic surgery. It also has been used to maintain pressure in leaking endotracheal tube cuffs. It is a very useful device, especially if the intubation is difficult or the patient's position precludes replacement of the endotracheal tube. Two patients are presented in whom the system was used to maintain endotracheal tube cuff pressure.