Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2003
Case ReportsPosition dependent ventricular tachycardia in two children with peripherally inserted central catheters (PICCs).
We report two cases of ventricular tachycardia (VT) in children following the insertion of peripherally inserted central catheters (PICCs). These children had additional procedures requiring turning into the left lateral position after PICC insertion. In both cases sustained VT occurred after turning and flexion of the arm with the PICC. VT was terminated in both cases by withdrawing the catheter.
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Paediatric anaesthesia · Jul 2003
Randomized Controlled Trial Clinical TrialEffects of systemic and epidural morphine on antidiuretic hormone levels in children.
Although the use of opioids during general anaesthesia suppresses stress response to surgery and pain, the effects on antidiuretic hormone (ADH) are controversial. The aim of this study was to find the effects of morphine with either intravenous infusion or epidural route on ADH and other stress hormones. ⋯ Despite the effective pain therapy and suppression of cortisol and insulin response to surgical stimulus, the increase in ADH secretion is not effected by systemic or epidural morphine administration.
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Paediatric anaesthesia · Jul 2003
Bradycardia with sevoflurane induction in patients with trisomy 21.
The authors present a series of three paediatric patients with trisomy 21 who developed significant bradycardia during inhalation induction with sevoflurane. All three were undergoing adenotonsillectomy. The possible association of such problems with trisomy 21 and treatment options are reviewed. Although the occurrence of bradycardia in these three patients may have been a random occurrence, given its occurrence in three of five consecutive patients with trisomy 21, a causal relationship may be involved and future observation of these patients appears warranted.
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Paediatric anaesthesia · Jul 2003
Randomized Controlled Trial Clinical TrialDose response study of caudal neostigmine for postoperative analgesia in paediatric patients undergoing genitourinary surgery.
Neostigmine given through the neuraxial route has been found to have analgesic properties. In this clinical trial, we evaluated for the first time the efficacy of a varying dose of caudal neostigmine for postoperative analgesia in children undergoing genitourinary surgery. ⋯ Caudal neostigmine in the dose range of 20-50 microgram.kg-1 provides dose dependent analgesia. However, dose exceeding 30 microgram.kg-1 is associated with a higher incidence of nausea and vomiting.
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Paediatric anaesthesia · Jul 2003
Case ReportsAnaesthetic management of a patient with achondroplasia.
A 12-year-old girl diagnosed with achondroplasia was admitted for bilateral ear surgery and adenotonsillectomy. She had classical symptoms and signs of upper airway obstruction, which is often seen in patients with achondroplasia. We describe the anaesthetic management of this patient, emphasizing the airway difficulties encountered and their anaesthetic implications.