Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2004
Randomized Controlled Trial Clinical TrialPostoperative behavioral changes following anesthesia with sevoflurane.
Behavioral disturbance following hospitalization is a relatively frequent event, some children still having negative behavioral changes (NBC) 1 month following their operation. Sevoflurane has a propensity to induce 'excitement' during induction of anaesthesia, and delirium in the immediate postoperative phase. The aim of this study was to evaluate whether this translates into prolonged behavioral change. ⋯ Children anesthetized with sevoflurane exhibit more immediate postoperative distress than those anesthetized with halothane. This difference is not carried over into the longer posthospital period. Negative behavioral changes occur more frequently with decreasing age.
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Paediatric anaesthesia · Oct 2004
Randomized Controlled Trial Comparative Study Clinical TrialTracheal sealing characteristics of pediatric cuffed tracheal tubes.
The aim of the study was to compare sealing characteristics of the new Microcuff pediatric tracheal tube featuring a high volume-low pressure (HVLP) cuff with ultrathin membrane with three conventional pediatric cuffed tracheal tubes. ⋯ This preliminary investigation suggests that the new Microcuff pediatric tracheal tube with ultrathin high volume-low pressure cuff membrane allows effective tracheal sealing at very low cuff pressures. This represents a benefit for children with regard to their lower mucosal perfusion pressures compared with adult patients.
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Paediatric anaesthesia · Oct 2004
Randomized Controlled Trial Comparative Study Clinical TrialCaudal analgesia in children: S(+)-ketamine vs S(+)-ketamine plus clonidine.
The aim of this study was to evaluate postoperative analgesia provided by caudal S(+)-ketamine and S(+)-ketamine plus clonidine without local anesthetic. ⋯ Caudal S(+)-ketamine 1 mg x kg(-1) and S(+)-ketamine 0.5 mg x kg(-1) plus clonidine 1 microg x kg(-1) are safe and provide effective postoperative analgesia in children without adverse effects.
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Paediatric anaesthesia · Oct 2004
Comment Randomized Controlled Trial Clinical TrialEarly intravenous cannulation in children during sevoflurane induction.
It has been shown that early placement of an intravenous line in children anesthetized with halothane is equally safe compared with later placement. Whether this is true of sevoflurane is not known. ⋯ Following an inhalation induction with sevoflurane in children, movement with intravenous placement was greater, and the incidence of laryngospasm was higher, when the intravenous access was attempted 30 s rather than 120 s following loss of lid reflex. We recommend waiting two min following the loss of lid reflex before attempting intravenous placement in children receiving an inhalation induction with sevoflurane.
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Paediatric anaesthesia · Oct 2004
Randomized Controlled Trial Clinical TrialRemifentanil vs fentanyl/morphine for pain and stress control during pediatric cardiac surgery.
Remifentanil is a short acting, potent synthetic opioid that does not accumulate after infusion or repeated bolus doses. It may be rapidly titrated to the requirements of individual patients. Titrated infusion of remifentanil may be able to provide potent analgesia required for pediatric cardiac surgery and obtund the stress response in theater whilst not having the persistent respiratory depression and sedation seen with longer acting opioids. ⋯ The only significant difference was in glucose in the postbypass time periods. Although statistically significant, this difference is insufficient evidence of increased stress in the remifentanil group. The results show that in the patients studied there was no clinically important difference between the two techniques.