Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2005
Anesthetic management of the neonate with congenital complete heart block: a 16-year review.
Anesthesia for patients with complete heart block can be associated with significant hemodynamic instability. The aim of this study is to review our anesthetic experience of neonates with congenital complete heart block (CCHB) who underwent placement of either a temporary epicardial pacing system or a permanent epicardial pacemaker. ⋯ Early institution of mechanical ventilation, inotropic support and pacing are necessary in the neonate with CCHB and poor hemodynamic function, particularly with coexisting CHD or prematurity.
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Paediatric anaesthesia · Dec 2005
Randomized Controlled TrialThe evaluation of propofol dosage for anesthesia induction in children with cerebral palsy with bispectral index (BIS) monitoring.
We designed a randomized prospective study to investigate whether developmentally delayed children with cerebral palsy (CP) need a lower dosage of propofol for induction than normal children using bispectral index (BIS) monitoring criteria. ⋯ Our data suggest that noncommunicative/nonverbal children with CP require less propofol to obtain the same BIS values (i.e. 35-45) than do otherwise healthy children.
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Paediatric anaesthesia · Dec 2005
Comparative Study Clinical TrialClonidine added to bupivacaine in neonatal spinal anesthesia: a prospective comparison in 124 preterm and term infants.
Spinal anesthesia (SA) remains the 'gold standard' in neonatal anesthesia for inguinal herniorrhaphy but its short duration impedes its usefulness. We previously demonstrated that clonidine prolongs neonatal SA without immediate side effects. ⋯ The clinical significance of short apneas, recovering spontaneously without desaturation, remains debatable. It is concluded that addition of clonidine to neonatal SA results in acceptable side effects. Side effects must be compared with the potential advantages before future recommendations.
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Paediatric anaesthesia · Dec 2005
Case ReportsSevere hepatotoxicity after sevoflurane anesthesia in a child with mild renal dysfunction.
Sevoflurane, an anesthetic agent with methyl isopropyl fluorinated ether structure, has a very low potential for hepatotoxicity. Nevertheless, a few cases of hepatotoxicity have been reported since its introduction into clinical practice. The underlying pathophysiology may be multifactorial and sometimes nonspecific. We report a case of severe hepatotoxicity after anesthesia with sevoflurane in a child with preexisting mild renal dysfunction.