Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2002
Randomized Controlled Trial Comparative Study Clinical TrialThe comparison of caudal ketamine, alfentanil and ketamine plus alfentanil administration for postoperative analgesia in children.
Our aim was to compare the effect of single dose caudal ketamine, alfentanil or a mixture of both drugs in the treatment of pain after hypospadias repair surgery in children. ⋯ Caudal administration of ketamine 0.5 mg.kg-1 with or without alfentanil in children produced satisfactory postoperative analgesia without respiratory depression or other side-effects.
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Paediatric anaesthesia · Sep 2002
Randomized Controlled Trial Clinical TrialThe addition of antiemetics to the morphine solution in patient controlled analgesia syringes used by children after an appendicectomy does not reduce the incidence of postoperative nausea and vomiting.
We studied the effect of intraoperative ondansetron 0.1 mg x kg(-1) or droperidol 0.01 mg.kg-1, followed by the same dose of the antiemetic agent added to the morphine solution during patient controlled analgesia (PCA) on the incidence of nausea and vomiting in children following an appendicectomy. ⋯ We were unable to show any significant benefit from the prophylactic administration of ondansetron or droperidol to children using morphine PCA devices following appendicectomy in the doses we employed.
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Paediatric anaesthesia · Sep 2002
Randomized Controlled Trial Clinical TrialPropofol or midazolam do not reduce the incidence of emergence agitation associated with desflurane anaesthesia in children undergoing adenotonsillectomy.
The aim of the study was to determine if concurrent use of short-acting sedatives would decrease the incidence of emergence agitation associated with desflurane while preserving rapid recovery. ⋯ The concurrent use of midazolam or propofol did not reduce the incidence of emergence agitation but did delay emergence and recovery. These agents are not recommended for reducing emergence agitation in children receiving desflurane.
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Paediatric anaesthesia · Sep 2002
Randomized Controlled Trial Clinical TrialAnalgesia for paediatric tonsillectomy and adenoidectomy with intramuscular clonidine.
After undergoing tonsillectomy and adenoidectomy (T&A), children may experience significant pain. Clonidine, an alpha2 agonist, exhibits significant analgesic properties. The current investigation sought to determine whether intramuscular (I.M.) clonidine would decrease pain in paediatric patients undergoing T&A. ⋯ We do not recommend adding i.m. clonidine (2 microg x kg(-1)) to the analgesic regimen of children undergoing tonsillectomy and adenoidectomy.
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A case of unexpected difficult laryngoscopy in a patient with gross hydrocephalus and generalized hypertonus is described. The 30-month-old girl had no antecedent history of such difficulty, having had two recent uneventful anaesthetics. We suggest that the reason for our inability to open the patient's mouth was a result of contracture of the temporalis muscle. The patient was managed using a laryngeal mask airway with controlled ventilation.