Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2001
Randomized Controlled Trial Comparative Study Clinical TrialMorphine with or without a local anaesthetic for postoperative intrathecal pain treatment after selective dorsal rhizotomy in children.
Selective dorsal rhizotomy is a surgical procedure with a selective division of posterior spinal nerve rootlets to treat spasticity in children. The extensive surgical procedure with multilevel laminectomies and the nerve root manipulation result in intense pain postoperatively. Two intrathecal (IT) regimes of pain treatment were compared in these children, concerning their pain relief and possible side-effects. ⋯ Bupivacaine/morphine resulted in a lower, but not significant, difference in pruritus and lower muscle spasm. Haemodynamic and ventilatory parameters did not differ between the groups. Intrathecal continuous infusion of bupivacaine and morphine was superior to intermittent morphine in the treatment of pain after selective dorsal rhizotomy operations.
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The purpose of this audit was the evaluation of recovery and discharge times and the identification of perioperative events related to anaesthetics with intravenous ketamine and midazolam. ⋯ Intravenous ketamine plus midazolam is a suitable, simple and fast anaesthetic technique for short, painful ambulatory procedures. Considering the possibility of potentially serious respiratory complications, it should be performed only by qualified anaesthesia staff who are trained in advanced airway management.
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Paediatric anaesthesia · Jan 2001
Randomized Controlled Trial Clinical TrialSublingual morphine may be a suitable alternative for pain control in children in the postoperative period.
The purpose of this pilot study was to compare the effects of sublingual morphine with intravenous morphine in the treatment of postoperative pain following adenotonsillectomy in children. Twenty-nine children scheduled for adenotonsillectomy were randomly assigned to group 1 (n=14) receiving 0.1 mg x kg(-1) sublingual morphine and group 2 (n=15) 0.1 mg x kg(-1) intravenous morphine followed by 1 mg x kg(-1) diclofenac rectally in both groups after induction of anaesthesia. ⋯ There was no statistical significant difference in any of these parameters between the two groups. The results suggest that sublingual morphine may be a suitable alternative to various other routes of opioid administration in children, but further investigations of the sublingual route of administration of opioids in children are required.
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Paediatric anaesthesia · Jan 2001
Bispectral index monitoring in children undergoing mild hypothermic cardiopulmonary bypass.
In this prospective, cohort study of 15 children (median age 7.7 years, range 4.9-16.5 years) undergoing atrial septal defect repair, we evaluated changes in the Bispectral index (BIS) as a potential monitor of level of consciousness during cardiac anaesthesia. ⋯ The increase in BIS during the rewarming phase could reflect an increase in conscious level, and is consistent with the reported risk for awareness during this phase of cardiac surgery.
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Paediatric anaesthesia · Jan 2001
Comparative StudyIs the sitting or the prone position best for surgery for posterior fossa tumours in children?
The aim of this study was to compare complications in children operated for posterior fossa tumours in the sitting position with those in the prone position. ⋯ PFT surgery in the sitting position in children is not associated with an increased number or severity of perioperative complications, while the postoperative course appears better in this position.