Current opinion in anaesthesiology
-
Curr Opin Anaesthesiol · Dec 2005
Anesthetic management of the child with an upper respiratory tract infection.
The decision to proceed with anesthesia for the child with an upper respiratory tract infection is often difficult. Whereas most studies suggest that children who present for elective procedures with an upper respiratory tract infection are at increased risk of perioperative adverse events, these events are typically easy to recognize and treat. This review will discuss the current literature regarding outcome in children who present for elective surgery with an upper respiratory tract infection and suggests approaches to optimize their perioperative management. ⋯ An understanding of the risk factors associated with administering anesthesia to the child with an upper respiratory tract infection is important in identifying elements of the preoperative assessment that merit attention and in optimizing the anesthetic plan as a means to limit any perioperative complications.
-
Closed system anaesthesia allows economic use of medical gases and volatile anaesthetics, maintenance of airway climatization and reduction of anaesthetic gas loss into the environment. In this context we reviewed papers addressing recent technical and clinical advances of closed system anaesthesia. ⋯ Modern feedback controlled ventilators allow the application of closed system anaesthesia as a safe and economic technique for routine clinical practice.
-
Curr Opin Anaesthesiol · Dec 2005
Clonidine: an alternative to benzodiazepines for premedication in children.
The aim of this review is to summarize the use of clonidine for paediatric premedication and to make a comparison with benzodiazepines. A routine clonidine premedication protocol is also presented. ⋯ Midazolam the most commonly used drug for paediatric premedication worldwide. Despite having a number of beneficial effects it is far from an ideal premedicant, especially concerning its effect on cognition/amnesia, confusion and long-term behavioural disturbances. Clonidine lacks the majority of the negative effects associated with midazolam and is associated with a number of beneficial perioperative effects. Our clinical experience of replacing midazolam with clonidine as premedicant in children, including also outpatients, has been favourable.