Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialWhich may be effective to reduce blood loss after cardiac operations in cyanotic children: tranexamic acid, aprotinin or a combination?
Children with cyanotic heart disease undergoing cardiac surgery in which cardiopulmonary bypass is used are at increased risk of postoperative bleeding. In this study, the authors investigated the possibility of reducing postoperative blood loss by using aprotinin and tranexamic acid alone or a combination of these two agents. ⋯ Our results suggested that both agents were effective to reduce postoperative blood loss and transfusion requirements in patients with cyanotic congenital heart disease. However, the combination of aprotinin and tranexamic acid did not seem more effective than either of the two drugs alone.
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Paediatric anaesthesia · Jan 2005
Randomized Controlled Trial Clinical TrialDose minimization study of single-dose epidural morphine in patients undergoing hip surgery under regional anesthesia with bupivacaine.
In order to decrease the rate of adverse effects, we aimed to identify the lowest analgesic dose of epidural morphine administered to patients undergoing hip surgery. ⋯ In patients undergoing hip surgery under regional anesthesia with bupivacaine, epidural morphine at a dose of 11.2 microg.kg(-1) administered immediately after completion of the procedure resulted in adequate pain relief for more than 12 h. Explanation of the high rate of patients vomiting (>45%) remains to be elucidated.
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Paediatric anaesthesia · Jan 2005
Sevoflurane sedation in infants undergoing MRI: a preliminary report.
Stillness during natural sleep after feeding may not be sufficient for successful magnetic resonance imaging (MRI) in small infants less than 5 kg. Sedation, using an oral agent, is often successful although the timing and depth of sedation is variable. In contrast anesthesia is always effective but is invasive and is associated with postanesthesia apnea and bradycardia in preterm and ex-preterm infants. We are developing an alternative technique involving insufflation of sevoflurane and present our initial experience. ⋯ Sedation by insufflation of sevoflurane in small infants is a simple and practical alternative technique for painless imaging such as MRI; further experience is necessary to determine its limitations.
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Paediatric anaesthesia · Jan 2005
Case ReportsAnesthetic management of a patient with MERRF syndrome.
There are several specific considerations regarding anesthesia in patients with mitochondrial disease. We describe the successful administration of a combined general and epidural anesthesia with sevoflurane maintenance in a patient with myoclonic epilepsy with ragged red fibers (MERRF syndrome) scheduled for surgical treatment of bilateral clubfoot.