Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2003
ReviewTracheomalacia and bronchomalacia in children: pathophysiology, assessment, treatment and anaesthesia management.
Tracheomalacia and bronchomalacia are becoming increasingly well recognized. Although pathologically benign conditions, they are responsible for considerable morbidity, occasional mortality and significant difficulties in the operating theatre and intensive care unit. We performed an extensive literature search to identify causal associations, methods of clinical and investigative assessment, treatment modalities and anaesthetic experience with these conditions.
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Paediatric anaesthesia · Jan 2003
The use of magnesium to prevent laryngospasm after tonsillectomy and adenoidectomy: a preliminary study.
Laryngospasm is the most common cause of upper airway obstruction after tracheal extubation. Magnesium has a central nervous system depressant property, which contributes to the depth of anaesthesia. It also has calcium antagonist properties, which provide muscle relaxation. In this study, we aimed to determine the effect of magnesium on preventing laryngospasm. ⋯ We found a significant decrease in the incidence of laryngospasm in paediatric patients receiving magnesium. It is suggested that the use of intravenous magnesium intraoperatively may prevent laryngospasm.
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Paediatric anaesthesia · Jan 2003
Randomized Controlled Trial Clinical TrialA comparison between local anaesthetic dorsal nerve block and caudal bupivacaine with ketamine for paediatric circumcision.
Ketamine has been shown to prolong analgesia produced by caudal local anaesthetic block and is now in common use. This study compares caudal block using bupivacaine/ketamine with dorsal nerve block of the penis. ⋯ Caudal anaesthesia with bupivacaine/ketamine does not confer any advantage over a dorsal nerve block with the doses used in this study. Because of the higher incidence of side-effects and technique failure in the caudal group, dorsal nerve block is perhaps the preferred technique.
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Paediatric anaesthesia · Jan 2003
Case ReportsPerioperative care of the child with the Johanson-Blizzard syndrome.
The Johanson-Blizzard Syndrome (JBS) is an autosomal recessive disorder with a characteristic phenotype, including dwarfism, a beaked nose with aplastic alae nasi, a high forehead, mid-line ectodermal scalp defects with sparse hair and absent eyelashes/eyebrows, prominent scalp veins, low set ears, a large anterior fontanelle, micrognathia, thin lips, absent permanent dentition and microcephaly. In addition to the characteristic facial features, associated conditions include congenital heart disease, exocrine/endocrine pancreatic dysfunction, hypothyroidism, hypopituitarism, mental retardation, sensorineural hearing loss and vesico-ureteral reflux. A case is presented and the potential anaesthetic implications of this syndrome are discussed.
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Paediatric anaesthesia · Jan 2003
Randomized Controlled Trial Clinical TrialRapid emergence does not explain agitation following sevoflurane anaesthesia in infants and children: a comparison with propofol.
Emergence agitation in children is frequently associated with the use of the new highly insoluble volatile anaesthetics. Rapid emergence has been cited as one of the possible causes. Propofol also permits rapid emergence from general anaesthesia but is not associated with agitation. ⋯ Although both sevoflurane and propofol allow for rapid emergence from general anaesthesia, only sevoflurane is associated with a high incidence of emergence agitation in infants and young children. Rapid emergence does not fully explain this phenomena.