Paediatric anaesthesia
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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.
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Paediatric anaesthesia · Jan 2005
Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane.
The purpose of the present study was to show that sevoflurane is a safe and effective agent for the sedation of newborns and infants who are to undergo magnetic resonance imaging (MRI) examinations. ⋯ Sevoflurane is an ideal agent for this type of diagnostic procedure in newborns and infants. We discuss the need for elaborating specific protocols for pediatric sedation and emphasize the strict observation of recommendations, which include the practical experience and up-to-date specialized training of the anesthesiologist carrying out sedation procedures in children.
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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
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.