Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialA comparison between ilioinguinal-iliohypogastric nerve block performed by anaesthetist or surgeon for postoperative analgesia following groin surgery in children.
A study was performed to compare postoperative analgesia in children undergoing groin surgery. Patients were randomly allocated to receive ilioinguinal-iliohypogastric (I-I) nerve blocks using 0.25% plain bupivicaine (0.5 ml.kg-1) performed either percutaneously by the anaesthetist after the induction of general anaesthesia, before surgery commenced, or intraoperatively, under direct vision, by the surgeon. ⋯ Statistical analysis of the results revealed no difference in pain score between groups treated either by anaesthetist or surgeon. However, children under two years of age had significantly higher pain scores than those over two.
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Paediatric anaesthesia · Jan 1995
Randomized Controlled Trial Clinical TrialThe effect of ketorolac as an adjuvant to local anaesthetic infiltration for analgesia in paediatric umbilical hernia surgery.
After umbilical hernia surgery, and wound infiltration with bupivacaine 0.5%, 17 children were given ketorolac 0.5 mg.kg-1, with 18 controls receiving only the wound infiltration. No child experienced severe pain, but moderate pain was noted in patients in both groups. Objective and subjective pain scores were not different statistically at any point up to the morning after surgery.
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Paediatric anaesthesia · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialPropofol reduces the incidence of vomiting after tonsillectomy in children.
We compared the effect of a propofol-based anaesthetic to an isoflurane-based anaesthetic on the incidence of postoperative vomiting in children following tonsillectomy. Thirty-nine children were enrolled in the study and randomized to receive one of the proposed anaesthetics. All patients underwent a mask induction with halothane, nitrous oxide, and oxygen. ⋯ Of 19 patients who received propofol, four vomited (21%); in contrast, of the 20 patients who received isoflurane, 11 vomited (55%). This difference is significant (P = 0.048 two-tailed Fisher's Exact Test). These data suggest that using propofol for anaesthesia can diminish the incidence of vomiting following tonsillectomy.
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A new regimen for postoperative analgesia after thoracic surgery is proposed. Eight children received an interpleural infusion using bupivacaine 0.1% in a regimen from 0.5 ml.kg-1.h-1 up to 1 ml.kg-1.h-1, for 48 h according to the pain scores. The plasma levels after 24 h and 48 h were measured as well as the pleural level and in two patients the free fraction of plasma bupivacaine and the plasma PPX (a metabolite of bupivacaine) and one patient the orosomucoid (main plasma protein involved in bupivacaine protein binding) were also measured pre and postoperatively. The results shows the safety of such a regimen, for two days of postoperative analgesia.
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Paediatric anaesthesia · Jan 1995
CRIES: a new neonatal postoperative pain measurement score. Initial testing of validity and reliability.
We have developed a neonatal pain assessment tool CRIES. The tool is a ten point scale similar to the APGAR score (Apgar 1953). It is an acronym of five physiological and behavioural variables previously shown to be associated with neonatal pain. ⋯ We have tested CRIES for validity and reliability. This report is the result of that testing. We have found CRIES to be valid, reliable and well accepted by neonatal nurses.