Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2003
Parents' perceptions and use of analgesics at home after children's day surgery.
Children are found to suffer from unnecessarily severe postoperative pain following day surgery. Reasons for parents' insufficient use of analgesics may be based on misleading perceptions of children's analgesics. The purpose of this study was to describe parents' perceptions and use of analgesics for children after discharge at home. ⋯ Parents tended to give analgesics to children who actually needed pain alleviation. Parents' perceptions of children's analgesics were mostly accurate. However, misleading perceptions of children's analgesics also exist among the parents. These misleading perceptions appear to decrease parents' use of children's postoperative pain medication.
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Paediatric anaesthesia · Feb 2003
Randomized Controlled Trial Comparative Study Clinical TrialBrachial plexus anaesthesia in children: lateral infraclavicular vs axillary approach.
Brachial plexus blockade is a well-established technique in upper-limb surgery. In paediatric patients, the axillary route is usually preferred to infraclavicular approaches because of safety considerations. Recent reports on a lateral infraclavicular approach offering greater safety in adults prompted us to perform a prospective randomized study to assess the analgesic efficacy of axillary vs lateral vertical infraclavicular brachial plexus (LVIBP) blocks in paediatric trauma surgery. ⋯ We conclude that LVIBP blocks can be safely performed in children and that they add to the spectrum of sensory and motor blockade seen with the axillary approach.
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Myotonic dystrophy is a neuromuscular condition inherited in an autosomal dominant fashion, and is most commonly diagnosed in the neonatal period. With improving levels of care, these patients are now presenting more commonly for anaesthesia. We review the clinical features of the condition, and then discuss the steps in the anaesthetic process, outlining the anaesthetic implications of myotonic dystrophy at each stage.
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Paediatric anaesthesia · Feb 2003
Comparative Study Clinical TrialA comparison of remifentanil and fentanyl for fast track paediatric cardiac anaesthesia.
Fast track anaesthetic protocols for cardiac surgical patients have been developed to facilitate early tracheal extubation. We compared anaesthetics based on either remifentanil or fentanyl for fast track paediatric cardiac anaesthesia. ⋯ The remifentanil based anaesthetic was associated with a significantly slower HR than the fentanyl based anaesthetic. The clinical implications of the slower HR during remifentanil anaesthesia could be important and should be investigated.
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Paediatric anaesthesia · Feb 2003
Case ReportsSingle-dose caudal anaesthesia for two infants undergoing diagnostic brain magnetic resonance imaging: high risk and nonhigh risk.
We present a case report of two infants given a bupivacaine caudal anaesthetic as a means of achieving sedation for a diagnostic brain magnetic resonance imaging (MRI). Patient 1 was born at 27 weeks of gestation and presented to our hospital at 39 weeks postconception with a history of bronchopulmonary dysplasia and apnoea/bradycardia spells. ⋯ Both infants fell asleep shortly after placement of the caudal blocks and the studies were completed successfully without complications. Utilizing this technique, we avoided dealing with a potentially difficult airway (patient 1), exacerbating postoperative apnoea and the negative implications of intravenous sedation during a study where there is limited access to the patient's airway.