Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2004
Case ReportsAnaesthetic management in a neonate with congenital complete heart block.
We present the case of a neonate undergoing surgery on the first day of life for the installation of a permanent pacemaker because of the existence of congenital complete heart block (CCHB) with a basal heart rate of 43 b.min(-1) and minimal elevation after initiating an isoproterenol perfusion. The intervention was under general anaesthesia with laryngeal mask airway (LMA) and spontaneous ventilation. The principal anaesthetic goals were to assure adequate anaesthesia, with haemodynamic and respiratory stability, to maintain the best possible heart rate and to avoid postoperative respiratory depression or apnoea.
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Paediatric anaesthesia · Feb 2004
Case ReportsThe laryngeal mask airway for administration of surfactant in two neonates with respiratory distress syndrome.
We report the successful use of the Classic laryngeal mask airway to provide brief access to the intratracheal space for the administration of surfactant in two neonates with respiratory distress syndrome.
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Paediatric anaesthesia · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialClinical and biochemical effects of propofol EDTA vs sevoflurane in healthy infants and young children.
Propofol is frequently used for the induction and maintenance of anaesthesia in children aged 3 years and older. The present study compared the clinical and chemical effects of propofol containing disodium edetate (Diprivan) with that of sevoflurane in children younger than 3 years of age. ⋯ In children younger than 3 years of age, propofol containing ethylenediaminetetraacetic acid has a similar profile to sevoflurane with respect to haemodynamic effects, recovery times, side-effects, ionized calcium and ionized magnesium levels.
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Paediatric anaesthesia · Feb 2004
Clinical TrialElectroencephalograph variables, drug concentrations and sedation scores in children emerging from propofol infusion anaesthesia.
Inadequate sedation or oversedation are common problems in Paediatric Intensive Care because of wide variations in drug response and the lack of objective tests for sedative depth. We undertook a pilot study to try to identify correlates of propofol drug concentration, electroencephalographic (EEG) variables and observed behaviour during a stepwise reduction in propofol infusion after paediatric cardiac surgery. ⋯ In this group of patients receiving opioid analgesia and relatively high doses of propofol, sedation scores were unhelpful in predicting arousal. The SR correlated with propofol blood concentrations and clinical arousal and may have potential as a predictive tool for arousal in children.
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Paediatric anaesthesia · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialThe clinical effect of mixing different proportions of rocuronium and mivacurium.
A synergistic effect has been described when rocuronium (Roc) and mivacurium (Miv) are combined in equal (i.e. 1:1) ED95 proportions at various total doses. We have investigated the effect of Roc or Miv alone and four different ratios (1:4, 2:3, 3:2 and 4:1) of Roc and Miv mixed to a total dose of 1.33 x ED95. The primary outcome is the ratio producing the maximum enhancement of duration of clinical effect. ⋯ Combinations of Roc and Miv show a synergistic effect, which appears maximal as the mixture approaches a 1:1 ratio of their ED95s. This combination acted as if a larger effective dose of a single (new) drug had been given, but did not offer the advantage of both rapid onset and short duration of effect.