Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1997
Case ReportsUnexpected interaction of methylphenidate (Ritalin) with anaesthetic agents.
We report difficulty with conscious sedation of a child taking methylphenidate for attention deficit disorder and possible delayed adverse interaction of ketamine and methylphenidate resulting in severe nausea, vomiting and dehydration. The effects of methylphenidate and its potential interactions with anaesthetic agents is discussed. We suggest that anaesthesiologists who provide sedation or anaesthesia to patients receiving methylphenidate be aware of the potential need for high sedative doses and the possibility of undesirable interactions.
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Paediatric anaesthesia · Jan 1997
Letter Case ReportsClonic convulsions in a neonate after propofol anaesthesia.
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Paediatric anaesthesia · Jan 1997
Case ReportsConservative management of tracheal rupture after intubation.
A case is reported of a newborn with tracheal rupture resulting from a complicated delivery requiring vacuum extraction and two attempts at intubation. Despite the severity of the situation the infant was successfully managed conservatively with orotracheal intubation.
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Paediatric anaesthesia · Jan 1997
Randomized Controlled Trial Multicenter Study Clinical TrialOndansetron reduces nausea and vomiting after paediatric adenotonsillectomy.
The efficacy, safety and resource implications of a single intravenous dose of ondansetron (0.1 mg.kg-1, maximum 4 mg) were assessed in a multinational, multicentre, randomized, double-blind, placebo-controlled trial of 427 children aged 1-12 years, undergoing tonsillectomy with/without adenoidectomy. Emesis (retching and/or vomiting) and nausea were analysed separately. Significantly more ondansetron-treated children had no episodes of emesis (127/212 (60%) vs 100/215 (47%); P = 0.004) and experienced no postoperative nausea (135/211 (64%) vs 108/213 (51%); P = 0.004) in the first 24 h. ⋯ Significantly fewer ondansetron-treated children were rescued or withdrawn from the study (5% vs 10%; P = 0.042). Fewer ondansetron-treated patients required nursing intervention (34% vs 45%; P = 0.007) and the average intervention time was significantly shorter (4.6 vs 8.1 minutes; P = 0.001). Resources used to manage PONV were significantly reduced by ondansetron (43% vs 57%; P = 0.014).
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Paediatric anaesthesia · Jan 1997
Comparative StudySpontaneous breathing with the use of a laryngeal mask airway in children: comparison of sevoflurane and isoflurane.
We compared respiratory parameters during anaesthesia with sevoflurane and isoflurane through a laryngeal mask airway (LMA). Children were anaesthetized with O2 and air with 2.3% (1MAC) sevoflurane (n = 20) or 1.5% (1MAC) isoflurane (n = 20). After insertion of LMA, patients were allowed to breathe spontaneously and respiratory rate (RR) and PECO2 were measured (presurgery state). ⋯ In the isoflurane group, mean RR and PECO2 were 32 breaths.min-1 and 6.1 kPa (46 mmHg) respectively, before surgery, and 37 breaths.min-1 and 6.7 kPa (52 mmHg) during surgery. There were no statistical differences between the two anaesthetic groups. Clinical respiratory and cardiovascular parameters during spontaneous breathing with LMA in children are similar during sevoflurane and isoflurane anaesthesia.