Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2001
Case ReportsCervical subcutaneous emphysema: an unusual complication of adenotonsillectomy.
Removal of the tonsils and adenoid tissue because of recurrent infection and/or respiratory obstruction is one of the most commonly performed operations. A rare complication during this intervention is subcutaneous surgical emphysema. The awareness of anaesthesiologists and otolaryngological surgeons will protect the patient from serious consequences. We report our experience with this complication and provide a review of the literature.
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Paediatric anaesthesia · Jul 2001
Case ReportsAnaesthetic management and high frequency oscillatory ventilation.
In an effort to decrease morbidity and mortality, newer modes of mechanical ventilation have been introduced into the critical care arena. One such technique, high frequency oscillatory ventilation (HFOV) relies on respiratory rates greater than 150 b.min-1, small tidal volumes, and the maintenance of a constant distending pressure thereby limiting peak inflating pressure and potentially the incidence of barotrauma. ⋯ We present three infants who represent the perioperative applications of HFOV: (i) elective preoperative use to minimize lung movement and interference with surgical exposure during thoracotomy and PDA ligation; (ii) intraoperative application when progressive alterations in respiratory compliance led to ineffective intraoperative ventilation/oxygenation; and (iii) anaesthetic care for a neonate already receiving HFOV. The techniques of HFOV and previous reports of perioperative use are reviewed.
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Paediatric anaesthesia · Jul 2001
ReviewReview of ethics in paediatric anaesthesia: research issues.
This is the second of a series of three articles reviewing the recent changes in the law in relation to ethics and the practice of paediatric anaesthesia. The review covers, in a practical question and answer format, the topics of consent, research, intensive care issues and organ donation in children.
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Paediatric anaesthesia · Jul 2001
Case ReportsAnaesthetic considerations for a child with combined Prader-Willi syndrome and mitochondrial myopathy.
We report the anaesthetic management of a child with Prader-Willi syndrome and mitochondrial myopathy for open heart surgery. We used ketamine, fentanyl, rocuronium and caudal morphine together with a propofol infusion with no untoward effects. The implications of both conditions for anaesthesia are discussed.