Paediatric anaesthesia
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The intravascular migration of an endhole epidural catheter in a child is described. We suggest measures to reduce the risk of inadvertent intravenous administration of local anaesthetic and means of reducing the effects of this with particular relevance to paediatric practice.
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Paediatric anaesthesia · Jan 1999
ReviewPaediatric head injury: incidence, aetiology and management.
Trauma is the commonest cause of hospital admission in children. Head injuries are present in 75% of children with trauma and 70% of all traumatic deaths are due to the head injury. ⋯ Therapeutic interventions will be discussed with specific emphasis on outcome studies. However, institution of adequate oxygen delivery and haemodynamic stability in the child at the earliest moment remains the most important aspect of the management plan.
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Paediatric anaesthesia · Jan 1999
Clinical TrialLaryngeal mask for difficult intubation in children.
We present a new intubation technique using an oral preformed tracheal tube passed through a laryngeal mask. Six patients (neonate to six months old) with craniofacial malformations of head and neck and scheduled for reconstructive plastic surgery are the basis of this report. An inhalation induction with increasing doses of halothane in oxygen while maintaining spontaneous ventilation was performed. ⋯ Once the mask was removed, the stylet was disconnected, and the 15 mm connector reattached. Our experience was that this takes about 20 to 30 s. We recommended this technique in paediatric patients in which a difficult intubation is foreseen.
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Paediatric anaesthesia · Jan 1999
Evaluation of the efficiency of heat and moisture exchangers during paediatric anaesthesia.
This study evaluates the efficiency of heat and moisture exchangers (HMEs) in allowing adequate humidification and warming during anaesthesia in children. Eighteen paediatric patients undergoing anaesthesia were divided into two groups: group A ten patients: infants up to 10 kg-->Hygrobaby HME; group B 8 patients: children above 10 kg-->Hygroboy HME. The following parameters were evaluated: body temperature (bT), room temperature (rT), fresh gas temperature, HME warm-up time, inspired and expired gases temperature and humidity, conserving efficiency, and duration of anaesthesia. ⋯ The conserving efficiency was good (0.93 in both groups). A positive correlation was found between efficiency and fresh gas temperature. HMEs did not meet the minimum standards for humidity and heating during anaesthesia in children, although their conserving efficiency was found to be satisfactory.
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Paediatric anaesthesia · Jan 1999
Case ReportsThe epidural dorsomedian septum as a possible cause for unilateral anaesthesia in an infant.
Unilateral epidural anaesthesia occurring in an infant is reported. An epidurogram revealed the presence of a midline structure suggestive of the dorsomedian septum. Epidural anatomy is reviewed and implications for threading epidural catheters in infants are discussed.