Paediatric anaesthesia
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Paediatric anaesthesia · May 2001
Clinical TrialPostoperative epidural analgesia with bupivacaine and fentanyl: hourly pain assessment in 348 paediatric cases.
The objective of this prospective study was the evaluation of the analgesia provided by an epidural infusion of bupivacaine and fentanyl after different types of surgery in children. ⋯ This combination of bupivacaine-fentanyl provides safe analgesia after major surgery in children with frequent clinical monitoring. Regular pain assessments of intensity and duration are useful to improve the quality of postoperative analgesia.
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Paediatric anaesthesia · May 2001
Clinical TrialThe prone position is associated with a decrease in respiratory system compliance in healthy anaesthetized infants.
Ten healthy (ASA I or II) anaesthetized infants undergoing clubfoot surgery were studied. General anaesthesia included rocuronium, nitrous oxide and isoflurane. Volume controlled ventilation (12 ml.kg-1) was delivered via a coaxial Mapleson-D (Bain) system and a Datex AS/3 ventilator. ⋯ Mean CDYN decreased from 14.9 +/- 4.9 ml.cmH2O-1 (supine) to 11.6 +/- 3.5 ml.cmH2O-1 (prone). Mean CSTAT decreased from 10.2 +/- 2.8 ml.cmH2O-1 (supine) to 8.9 +/- 2.3 ml.cmH2O-1 (prone). No clinically significant differences in gas exchange were noted, however, on repositioning.
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We wished to determine a consensus view from UK paediatric anaesthetic consultants of what practical skills are safe and appropriate for an anaesthetic trainee to perform during an initial 3-month module in paediatric anaesthesia. ⋯ Anaesthetic registrars undertaking an initial module in paediatric anaesthesia should learn basic airway management, ilioinguinal blocks, penile blocks and caudals (but not neonatal caudals).
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Paediatric anaesthesia · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialA prospective randomized controlled study of the efficacy of ketamine for postoperative pain relief in children after adenotonsillectomy.
Adenotonsillectomy is commonly needed by children with obstructive sleep apnoea syndrome. This population is at high risk of life threatening airway obstruction in the postoperative period. ⋯ Ketamine is a safe and effective alternative to morphine to provide analgesia in the immediate postoperative period after tonsillectomy.