Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2005
Case ReportsUse of intravenous midazolam and clonidine in cyclical vomiting syndrome: a case report.
We report a case of a teenage boy with cyclical vomiting syndrome (CVS) who was referred to the anesthesia-run postoperative pain service for symptom management. His symptoms were uncontrolled by oral pizotifen prophylaxis and acute therapy with intravenous (IV) hydration and ondansetron. A continuous low dose IV midazolam infusion was added to his treatment regimen (as is instituted for recalcitrant postoperative nausea and vomiting) with benefit, but not total symptom resolution. ⋯ Many agents have been used in CVS therapy but no trials have been done. Neither midazolam nor clonidine has been reported previously as used in the treatment of CVS. The apparent success of this combination raises possibilities both for future trials and research into the pathogenesis of CVS.
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We report a potentially life-threatening tracheal lesion that caused postextubation stridor in a child following dental surgery. The child developed a cough, dysphonia, stridor, and respiratory distress hours after his operation. Standard therapy for postextubation stridor was ineffective. ⋯ This revealed a fibrinous membrane that was attached to the anterior trachea and required mechanical ablation. The child made an uneventful recovery. This lesion has not been reported in children before and we believe that it is important in the differential diagnosis of postextubation stridor as it requires specific therapy.
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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
Clinical TrialPropofol total intravenous anesthesia for MRI in children.
The aim of this study was to assess clinical signs of airway patency, airway intervention requirements and adverse events in 100 children receiving propofol total intravenous anesthesia for magnetic resonance imaging, with spontaneous ventilation and oxygenation via nasal prongs. ⋯ This study demonstrates good preservation of upper airway patency and rapid recovery using general anesthetic doses of propofol in children.
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Paediatric anaesthesia · Jan 2005
Case ReportsTotal spinal anesthesia during combined general-epidural anesthesia in a 7-year-old child.
Total spinal anesthesia (TSA) is a rare complication of lumbar epidural anesthesia through inadvertent spinal injection of local anesthetics following an undiagnosed dural breach or spinal placement of the catheter. TSA has rarely been reported in children. ⋯ Recent previous lumbar punctures and intrathecal chemotherapy for Burkitt's lymphoma at the same level may have facilitated dural breach. Epidural anesthesia should not be attempted at the same intervertebral level as prior recent lumbar punctures.