Paediatric anaesthesia
-
Paediatric anaesthesia · Jul 2001
Survey of the use of oesophageal and precordial stethoscopes in current paediatric anaesthetic practice.
The aim of the study was to examine the use of oesophageal and precordial stethoscopes for monitoring in current paediatric anaesthetic practice in the UK and Ireland. ⋯ Use of the stethoscope as a continuous monitor has decreased and most anaesthetists feel it has been superseded by other monitoring. However, almost one-third of anaesthetists recorded critical incidents they had been involved with where an oesophageal or precordial stethoscope detected the incident early. Complications of these monitoring devices were rare and the main factors limiting their use was the presence of better monitoring, such as pulse oximetry and capnography, and lack of availability.
-
Paediatric anaesthesia · Jul 2001
Case ReportsAnaesthetic management of a child with a positive family history of malignant hyperthermia for posterior fossa surgery in the sitting position.
A 6-year-old boy with a positive family history of malignant hyperthermia presented for posterior fossa craniectomy and excision of medulloblastoma. A nontriggering anaesthetic was therefore planned using infusions of propofol and remifentanil and a vapour free anaesthetic system delivering an oxygen/air mixture. The surgery was carried out with the child in the sitting position.
-
Paediatric anaesthesia · Jul 2001
Randomized Controlled Trial Clinical TrialDistal oesophageal pH measurement in children during general anaesthesia using the laryngeal mask airway, tracheal tube and face mask.
Distal oesophageal pH was measured during controlled ventilation in children with the laryngeal mask airway (LMATM), tracheal tube (TT) and face mask (FM). ⋯ There was no difference in the median pH values, within and between the groups (P > 0.05). We conclude that there is no difference in gastro-oesophageal reflux, when using a LMA, TT or FM during controlled ventilation in anaesthetized children.
-
Paediatric anaesthesia · Jul 2001
Case ReportsComplicated airway management in a child with prune-belly syndrome.
We describe a 15-month-old boy with prune-belly syndrome (PBS) in whom airway management was complicated. Following an inhalation induction using sevoflurane, tracheal intubation by direct laryngoscopy proved impossible after repeated attempts. A laryngeal mask airway (LMAtrade mark) was inserted and the child had an uneventful anaesthetic course.
-
Paediatric anaesthesia · Jul 2001
Prediction of difficult airway in school-aged patients with microtia.
Because the ear and mandible develop from the first and second branchial arches and first branchial cleft, abnormalities of the ear may be a sign that intubation will be difficult. We hypothesized that children with microtia would have a greater incidence of difficult laryngeal visualization with conventional rigid laryngoscopy compared to those with normal facial anatomy. ⋯ There was a strong positive correlation between the number of involved abnormal anatomical components according to the OMENS classification and the degree of difficult visualization of the larynx in patients with both bilateral and unilateral microtia (Spearman rank order correlation coefficient=0.85 and 0.88, respectively).