Paediatric anaesthesia
-
Paediatric anaesthesia · Jan 2001
Case ReportsCombination propofol-ketamine anaesthesia in sick neonates.
Two critically ill, opioid-tolerant neonates were anaesthetized using pancuronium and a mixture of propofol (PROP) and ketamine (KET). Three mg of KET were added per ml (10 mg) of PROP in a single syringe and infused at a rate of 100-150 microg x kg(-1) x min(-1) of the PROP component (30-45 microg x kg(-1) x min(-1) KET). ⋯ Both patients remained haemodynamically stable throughout their surgical procedures. PROP-KET is a rational and effective combination for intravenous anaesthesia in critically ill neonates who are likely to be opioid-tolerant when an anaesthesia vaporizer is not readily available.
-
Paediatric anaesthesia · Jan 2001
Case ReportsA technique for maintenance of airway access in infants with a difficult airway following tracheal extubation.
Tracheal extubation of patients with a difficult airway represents a challenge to anaesthesiologists and intensive care physicians. While a variety of techniques designed to maintain access to the airway in case of the need for tracheal reintubation have been described in adults, no reports have been published in infants and young children. We describe an approach to this issue in a young child with severe micrognathia.
-
Paediatric anaesthesia · Jan 2001
Case ReportsAnaesthetic management of an adolescent for scoliosis surgery with a Fontan circulation.
Advances in the treatment of congenital heart disease have led to a new group of adolescents or adults patients with cardiac anomalies. The anaesthetic management of these patients can be challenging especially when they are scheduled for major noncardiac surgery inducing haemodynamic instability. We report the case of a 14-year-old boy scheduled for posterior spinal fusion for idiopathic scoliosis who underwent a Fontan operation in infancy for pulmonary atresia with right ventricle hypoplasia. The preoperative investigations and the anaesthetic management are described.
-
Paediatric anaesthesia · Jan 2001
Case ReportsDifficult airway management of a child impaled through the neck.
We report the difficult airway management of a child impaled through the neck by a wooden plant support. The various options are discussed and the involvement of experienced personnel together with a clear preformulated plan of action is stressed.
-
Paediatric anaesthesia · Jan 2001
Case ReportsContinuous axillary block for upper limb surgery in a patient with epidermolysis bullosa simplex.
We report the use of continuous regional block with light general anaesthesia in epidermolysis bullosa simplex. A 4-year-old girl suffering from florid epidermolysis bullosa simplex was scheduled for external fixator (JESS) for manus valgus deformity of the left forearm. Haemoglobin was 7.6 g.dl(-1) and blood chemistry was normal. ⋯ The axilla remained free of problems. Continuous peripheral plexus or nerve blocks can be an option in these difficult patients, and can minimize the amount of general anaesthesia along with problems of airway handling and potential subsequent mucosal lesions. The postoperative period was pain free and comfortable.