Paediatric anaesthesia
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Paediatric anaesthesia · May 2001
Biography Historical ArticleAn appreciation of Dr. Gordon Jackson Rees FRCA, FRCP, FRCPCH: pioneer of paediatric anaesthesia.
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Paediatric anaesthesia · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative nausea and vomiting in paediatric ambulatory surgery: sevoflurane versus spinal anaesthesia with propofol sedation.
Descriptive data report a very low rate of postoperative nausea and vomiting (PONV) following spinal anaesthesia in children. In an attempt to corroborate this observation, we designed a prospective randomized study to compare spinal anaesthesia with intravenous propofol sedation (SA) (n=21) to inhalational sevoflurane anaesthesia (IA) (n=19) with regard to PONV and postoperative analgesia in children (aged 3-12 years) undergoing ambulatory inguinal surgery. ⋯ Despite the reduced number of emetic episodes and the better immediate postoperative analgesia associated with spinal anaesthesia, no difference could be identified between the two different anaesthetic protocols regarding time to discharge or overall patient satisfaction. Thus, despite minor advantages associated with spinal anaesthesia with propofol sedation, both anaesthetic regimen appear equally suitable for use in the paediatric outpatient setting.
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Paediatric anaesthesia · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialPropofol/remifentanil versus propofol alone for bone marrow aspiration in paediatric haemato-oncological patients.
This prospective randomized study was designed to evaluate the effects of adding remifentanil to the standard propofol-based technique in the setting of paediatric haematology-oncology outpatient clinic. ⋯ The addition of remifentanil improved the conditions during the procedure and reduced the total amount of propofol, as well as the time to home readiness. However, the addition of remifentanil is associated with an increased risk of respiratory depression.
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Paediatric anaesthesia · May 2001
Parents' preferences for participation in decisions made regarding their child's anaesthetic care.
The traditional paternalistic approach to medical decision-making is moving towards a climate of greater patient and/or surrogate involvement. Despite this, there is considerable debate regarding patient preferences for participation in medical decision-making and its effect on patient satisfaction and outcome. This study was designed to examine parents' preferences for participation in decisions regarding their child's anaesthetic care and to determine if active participation is associated with greater parental satisfaction. ⋯ This study highlights specific areas in which parents would prefer a more active role in decision-making and, as such, may serve to focus anaesthetists' efforts to educate parents with respect to the various options available for their child's care.
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Paediatric anaesthesia · May 2001
Teaching and supervising tracheal intubation in paediatric patients using videolaryngoscopy.
In 85 patients (mean age 4.6 +/- 3.1 years, range 0-10 years), a prototype of a new videolaryngoscope was used to provide a display of the intubation procedure in a paediatric anaesthesia teaching unit. The device provided important information to the teacher about the trainee's problems related to direct laryngoscopy, difficulties with tube insertion into the larynx as well as the need and extent for anterior laryngeal pressure. Because the videolaryngoscope did not impair the normal intubation procedure, it seems to be a safe and a benefical tool for teaching and supervising tracheal intubation in children. In addition, it provides a potentially useful aid during difficult laryngoscopy, since the monitor view of the vocal cords was significantly better compared with a direct laryngoscopic view (P < 0.001).