Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2003
Case ReportsLaryngeal mask airway guided fibreoptic tracheal intubation in a child with a lingual thyroglossal duct cyst.
The establishment of a tracheal airway with direct laryngoscopy can either be difficult or impossible in children with airway pathology. Multiple direct laryngoscopic attempts cause oedema and/or bleeding with subsequent difficult ventilation. The techniques utilizing the laryngeal mask airway (LMATM) and the fibreoptic bronchoscope have been reported. The case of a child with lingual thyroglossal duct cyst in which the LMA was useful to secure the airway and as a conduit for fibreoptic tracheal intubation is reported.
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Paediatric anaesthesia · Nov 2003
Clinical TrialEvaluation of a new combined SpO2/PtcCO2 sensor in anaesthetized paediatric patients.
The recently introduced TOSCA monitor (Linde Medical Sensors AG, Basel, Switzerland) combines pulse oximetry (SpO2) and transcutaneous PCO2 (PtcCO2) monitoring in a single ear sensor. The aim of the present study was to evaluate accuracy of the TOSCA monitor to estimate SaO2 and PaCO2 in anaesthetized children. ⋯ In anaesthetized children, the TOSCA ear sensor allows estimation of SaO2 and PaCO2, comparable in accuracy to endtidal capnometry and finger pulse oximetry. This makes the TOSCA monitor a helpful add-on to respiratory monitoring in anaesthetized children, in situations, in which endtidal capnometry is unreliable or difficult to establish.
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Paediatric anaesthesia · Nov 2003
Randomized Controlled Trial Comparative Study Clinical TrialPretreatment with intravenous ketamine reduces propofol injection pain.
Paediatric procedural sedation using propofol has been shown to be safe and effective and is widely used. Pain at the injection site is a frequent complaint and can be particularly distressing for children, especially for those undergoing repeated procedures. Ketamine has analgesic properties and can diminish the incidence of propofol infusion pain in adults. The aim of the study was to investigate whether pretreatment with ketamine would reduce infusion line pain in propofol sedation in children. ⋯ Pretreatment with ketamine (0.5 mg.kg-1) is very effective in preventing propofol infusion pain.
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Paediatric anaesthesia · Nov 2003
Epidural analgesia in children. A survey of current opinions and practices amongst UK paediatric anaesthetists.
Despite the widespread use of epidural analgesia in children its place in paediatric pain management has not been clearly established. In order to investigate the current practice of paediatric epidural analgesia in the UK paediatric anaesthetists and paediatric pain management teams were surveyed. ⋯ There is wide variation in the practice of paediatric epidural analgesia in the UK. Inconsistencies are likely to be related to the poor evidence base available to guide clinical decision making and the lack of a specialized paediatric acute pain service in some centres. More research is required to determine the optimal management of epidural analgesia, and suitable clinical support for paediatric pain control should be more widely available.