Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2002
Randomized Controlled Trial Clinical TrialPreemptive diclofenac reduces morphine use after remifentanil-based anaesthesia for tonsillectomy.
We investigated the effect of preincisional rectal diclofenac on pain scores and postoperative morphine requirements of children undergoing tonsillectomy after remifentanil-propofol anaesthesia in a randomized clinical trial. ⋯ Preemptive diclofenac given rectally reduced pain intensity and morphine requirements of children anaesthetized with remifentanil for tonsillectomy.
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Paediatric anaesthesia · Oct 2002
Randomized Controlled Trial Clinical TrialUnconscious sedation in children: a prospective multi-arm clinical trial.
We report the evaluation of six sedative-hypnotic and analgesic combinations administered to children undergoing brief periods of unconscious (or deep) sedation for painful procedures. ⋯ The combination of methohexital and remifentanil appears to be a satisfactory method for unconcious sedation for short painful procedures in children.
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Paediatric anaesthesia · Oct 2002
ReviewThe choice of inhalation anaesthetic for major abdominal surgery in children with liver disease.
Many children with liver disease undergo major abdominal surgery. Maintenance of anaesthesia is thus an important consideration in this surgical population. Despite a comprehensive and painstaking review of the literature, a sound evidence base, on which a choice of inhalation anaesthetic may be made, is lacking due to limited research in these patients. ⋯ Sevoflurane is favoured in paediatric practice for gaseous induction, but desflurane or isoflurane are marginally the preferred agents for maintenance of anaesthesia in children with liver disease undergoing major abdominal surgery. However, on the evidence that exists, much of it admittedly in animals and in adults, all three are preferable to halothane in this group of patients. More work is needed in this area before sound conclusions can be drawn and one agent proved to be definitely superior to the others.
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Paediatric anaesthesia · Oct 2002
Case ReportsJet ventilation for anterior paediatric scoliosis surgery.
Single-lung anaesthesia for thoracotomy is usually achieved with endobronchial intubation, a double-lumen tube or an endobronchial blocker. High-frequency jet ventilation (HFJV) is seldom described for thoracotomy in children, although it is used for both laryngology procedures in the operating room and as a ventilation mode in intensive care. HFJV was used in three children, aged 10-12 years, who presented for scoliosis correction involving thoracotomy. ⋯ Surgical opening of the nondependent lung pleura resulted in sufficient collapse of the pulmonary parenchyma with the patient in the lateral decubitus position for the surgical procedure. Arterial blood gas analyses performed during thoracotomy were within normal limits, with no CO2 retention. HFJV is an alternative ventilation strategy for thoracotomy in children because of its unique ability to deliver small tidal volumes at low mean airway pressures via a narrow catheter.
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Paediatric anaesthesia · Oct 2002
Flush volumes delivered from pressurized bag pump flush systems in neonates and small children.
The aim of this study was to measure the volumes of fluid delivered with a fast flush bolus from a flow regulating device. ⋯ Fast bolus flushing from pressurized infusion bag systems, using the flow regulating device tested, can be applied during neonatal and paediatric anaesthesia without delivering uncontrolled amounts of fluid.