Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2001
Case ReportsMediastinal mass obscured by a large pericardial effusion in a child: a potential cause of serious anaesthetic morbidity.
Anaesthesia in the presence of a mediastinal mass is known to be hazardous. We report a case of a 5-year-old boy with a presumed postviral pericardial effusion presenting for pericardiocentesis under general anaesthesia. ⋯ The reasons for misdiagnosis, mechanisms for perioperative complications and optimal management are discussed. Mediastinal masses and underlying malignancy should always be considered in patients with large pericardial effusions.
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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.
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Paediatric anaesthesia · Jul 2001
Early tracheal extubation after paediatric cardiac surgery: the use of propofol to supplement low-dose opioid anaesthesia.
After institutional approval and parental consent, 103 children, aged 6 months to 18 years, who were undergoing repair of simple and complex congenital heart lesions using cardiopulmonary bypass (CPB) were studied and compared with a group of 135 children who had undergone similar surgery in our institution in the year before. ⋯ We found the propofol regimen to be satisfactory with a shorted ICU stay for these patients.
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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
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).