Paediatric anaesthesia
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A 2 year-old boy presented with acute upper airway obstruction following a 15-month history of noisy breathing and hoarseness. An urgent laryngotracheal bronchoscopy was performed following inhalational induction of anesthesia. ⋯ Twelve days later, the tracheostomy was successfully decannulated with the child's voice beginning to normalize. The family remembered the decoration from Christmas celebrations 2 years prior and recalled a coughing episode that predated the onset of hoarseness.
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Paediatric anaesthesia · Dec 2004
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of epidural vs intravenous analgesia for posterior spinal fusion surgery.
The study objective was to compare epidural vs intravenous postoperative analgesia in posterior spinal fusion surgery patients. ⋯ By evaluating morphine sulfate usage between groups, the analgesic effectiveness of continuous thoracic epidural analgesia bupivacaine and fentanyl doses used revealed no significant improvement over intravenous morphine sulfate analgesia alone in patients after posterior spinal fusion surgery.
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Paediatric anaesthesia · Dec 2004
Comparative Study Clinical TrialS-ketamine and s-norketamine plasma concentrations after nasal and i.v. administration in anesthetized children.
It has been suggested that nasal administration of s-ketamine may be used to improve sedation or premedication in combination with nasal midazolam in pediatric patients. In this study we measured and compared plasma concentrations of s-ketamine and its main metabolite s-norketamine after nasal and i.v. administration in preschool children. ⋯ Nasal administration of s-ketamine 2 mg x kg(-1) results in a wide spread of plasma concentrations and absorption times. Rapid and high level drug absorption after nasal drug administration is possible. The use of a pulse oximeter and continuous observation after nasal administration of s-ketamine for pediatric premedication is recommended.
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Paediatric anaesthesia · Dec 2004
Randomized Controlled Trial Comparative Study Clinical TrialA randomized, double-blind comparison study of EMLA and ELA-Max for topical anesthesia in children undergoing intravenous insertion.
Topical anesthetics may help reduce discomfort associated with procedures involving needle-puncture, such as intravenous (i.v.) insertions, in children. EMLA cream has become a common, noninvasive therapy for topical anesthesia in children. ELA-Max is a recently introduced topical anesthetic cream marketed as being as effective in producing topical anesthesia after a 30-min application as EMLA is after a 60-min application. The purpose of this research was to compare ELA-Max at 30 min with EMLA at 60 min for providing topical anesthesia for i.v. insertions in children. ⋯ Results from this study support the claim that a 30-min application of ELA-Max (with occlusion) is as effective as a 60-min application of EMLA (with occlusion) for producing topical anesthesia for i.v. insertion in children.
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Paediatric anaesthesia · Dec 2004
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialOral clonidine does not change ventilatory response to carbon dioxide in sevoflurane-anesthetized children.
Clonidine is a useful premedicant for pediatric anesthesia. The drug has potential for ventilatory depression. The aim of the current study was to determine the effects of clonidine premedication on the ventilatory response to hypercapnia during sevoflurane anesthesia using the carbon dioxide (CO(2)) steady state method. ⋯ These data suggest that oral clonidine is a suitable premedication for sevoflurane anesthesia under spontaneous breathing conditions in children.