Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2004
Case ReportsAxillary brachial plexus block for treatment of severe forearm ischemia after arterial cannulation in an extremely low birth-weight infant.
Severe limb ischemia after arterial catheterization in neonates and premature infants is a well-recognized problem. The usual treatment of ischemic injuries includes removal of the catheter and elevation of the effected limb. If unsuccessful, tissue necrosis and loss may follow. ⋯ Immediate removal of the arterial line did not improve ischemia. Thirty-six hours later a brachial plexus block via the axillary approach with 0.5 ml bupivacaine 0.125% was performed resulting in rapid improvement, restricting ischemia eventually to fingers II-V as well as the distal part of the thumb. Brachial plexus blockade and active vasodilatation in tiny neonates after severe local ischemia are discussed.
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Paediatric anaesthesia · Aug 2004
Case ReportsAnesthetic management of a patient with myotonic dystrophy for a Nissen fundoplication and gastrostomy.
A 16-month-old baby with myotonic dystrophy underwent an open Nissen fundoplication and gastrostomy insertion under general anesthesia with an epidural. Postoperative care was managed on the pediatric intensive care unit for the first 6 h. She was then discharged to the ward, where she continued to make an uncomplicated recovery. Other anesthetic management that has been used in children with myotonic dystrophy is discussed.
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Paediatric anaesthesia · Aug 2004
Comment Letter Case ReportsA rare cause of upper airway obstruction in a 5-year-old girl: a laryngeal web.
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Paediatric anaesthesia · Aug 2004
Letter Case ReportsAnesthetic management in a child with Coffin-Siris syndrome.
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Infants placed on extracorporeal membrane oxygenation (ECMO) or mechanical ventilation often need continuous morphine infusions for pain relief and sedation. The resulting physical dependence requires an additional 2-3-week hospital stay to taper the morphine to avoid withdrawal. Buprenorphine effectively blocks abstinence in dependent adults, and in infants it could accelerate or eliminate the tapering schedule, thereby enabling earlier hospital dismissals. ⋯ Buprenorphine may prove to be a suitable drug for treating opioid withdrawal in human infants.