Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1996
Oxygen enrichment of entrained room air during Venturi jet ventilation of children undergoing bronchoscopy.
Intermittent oxygen jet ventilation at an inspiratory:expiratory ratio of 1:3 was used to ventilate 15 children undergoing rigid Storz bronchoscopy for removal of inhaled foreign body. Oxygenation of the patient was continuously monitored by pulse oximetry. In all children SpO2 was above 95% when the bronchoscope was above the carina. ⋯ Oxygen jet ventilation during bronchoscopy is based on the Venturi principle; the oxygen jet will entrain room air from the side arm of the bronchoscope which functions as an entrainment orifice. This will decrease the FIO2. The FIO2 can be increased by flowing oxygen continuously via the T-piece attached to the side arm of the bronchoscope.
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialPosttonsillectomy vomiting. Ondansetron or metoclopramide during paediatric tonsillectomy: are two doses better than one?
This randomized, double blinded, placebo controlled, prospective study compared the anti-emetic efficacy of one preoperative dose of metoclopramide 0.25 mg.kg-1 intravenously or ondansetron 0.15 mg.kg-1 intravenously with two doses of the same drugs (second dose administered one h postoperatively) in 200 preadolescent children undergoing tonsillectomy with either isoflurane or propofol anaesthesia. The incidence of posttonsillectomy vomiting was significantly reduced (P < 0.005) by two doses of either metoclopramide or ondansetron (18% and 8%, respectively) compared with placebo (50%). No difference in posttonsillectomy vomiting exists between the children who received isoflurane and those who received a propofol infusion. Our results suggest that two doses of metoclopramide 0.25 mg.kg-1 intravenously, like two doses of ondansetron 0.15 mg.kg-1, are effective in reducing vomiting after tonsillectomy in children who have received either isoflurane or propofol anaesthesia.
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of 25 G and 29 G Quincke spinal needles in paediatric day case surgery. A prospective randomized study of the puncture characteristics, success rate and postoperative complaints.
A comparison of a 25 G with a 29 G Quincke needle was performed in paediatric day case surgery. Sixty healthy children aged 1 year to 13 years were randomly allocated to have spinal anaesthesia with either 25 G or 29 G Quincke needle without an introducer needle. There was a failure rate of 10% with the 29 G spinal needle compared with 0% with the 25 G needle. ⋯ In conclusion, lumbar puncture without introducer needle was possible with both needles. The puncture characteristics favoured the 25 G needle. A shorter needle could partly alleviate the difficulties with the 29 G needle.
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of diclofenac and tenoxicam for postoperative analgesia with and without fentanyl in children undergoing adenotonsillectomy or tonsillectomy.
127 children scheduled for elective tonsillectomy or adenotonsillectomy were studied. Anaesthesia was induced with propofol and maintained with a volatile agent. At induction the child received either rectal diclofenac 1 mg.kg-1 with or without fentanyl 0.75 microgram.kg-1 i.v., or intravenous tenoxicam 0.4 mg.kg-1 with or without fentanyl 0.75 microgram.kg-1 i.v. ⋯ Pain scores in the tenoxicam without fentanyl group were significantly higher in recovery (P < 0.05) than the diclofenac group without fentanyl and both fentanyl groups. This group required supplemental analgesia earlier although this was not significant. The pain scores in the diclofenac with fentanyl group were significantly lower at one h and four h than the group receiving diclofenac alone (P = 0.008 and 0.02 respectively).