Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2005
Case ReportsDelayed onset refractory dystonic movements following propofol anesthesia.
Neuroexcitation is an uncommon but well recognized side effect of propofol anesthesia and sedation. We present a patient who, despite an intact mental status and without any preexisting movement disorder, experienced delayed onset of involuntary dystonic movements involving head, neck and shoulder for 11 h following emergence from propofol/nitrous oxide anesthesia.
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Paediatric anaesthesia · Jul 2005
Risk factors influencing inadvertent hypothermia in infants and neonates during anesthesia.
The factors affecting the thermal status in neonates and infants undergoing general anesthesia are not yet investigated in detail. We evaluated the factors leading to intraoperative hypothermia in 60 neonates and infants. ⋯ The type of surgery and the OR temperature are the main factors for decrease of the core temperature in neonates and infants. In neonates, the core temperatures are less stable, regardless of OR temperature and type of surgery. In high OR temperature, infants can stabilize their core temperature better than neonates.
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Paediatric anaesthesia · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialComparative evaluation of midazolam and ketamine with midazolam alone as oral premedication.
Oral premedication with midazolam and ketamine is widely used in pediatric anesthesia to reduce emotional trauma and ensure smooth induction. However, various dosing regimens when used alone or in combination have variable efficacy and side effect profile. The aim of our study was to investigate and compare the efficacy of oral midazolam alone with a low-dose combination of oral midazolam and ketamine. ⋯ Oral midazolam alone and a combination of midazolam with ketamine provide equally effective anxiolysis and separation characteristics. However, the combination provided more children in an awake, calm and quiet state who could be separated easily from parents.
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Paediatric anaesthesia · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effects of clonidine and ketamine added to ropivacaine on stress hormone levels and the duration of caudal analgesia.
The purpose of this study was to compare the analgesic quality and duration of ropivacaine 0.2% with the addition of clonidine (1 microg.kg(-1)) with that of ropivacaine 0.2% and the addition of ketamine (0.5 mg.kg(-1)) to that of ropivacaine 0.2% and also compare the postoperative cortisol, insulin and glucose concentrations, sampled after induction and 1 h later following caudal administration in children. ⋯ Addition of ketamine and clonidine to ropivacaine 0.2% 0.75 ml.kg(-1), when administered caudally in children, prolongs the duration of postoperative analgesia. The need for subsequent postoperative analgesic is also reduced. Caudal analgesia attenuates or allows partial changes to postoperative cortisol, insulin or blood glucose responses to surgery.
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Paediatric anaesthesia · Jul 2005
Randomized Controlled Trial Clinical TrialClonidine administered as adjuvant for bupivacaine in ilioinguinal-iliohypogastric nerve block does not prolong postoperative analgesia.
Coadministration of clonidine with local anesthetics is associated with improvement of the quality of peripheral nerve block and significant prolongation of postoperative analgesia. Better analgesia has been reported with clonidine in ilioinguinal nerve block compared with caudal use. The object of this study was to determine whether adding of 1 microg.kg(-1) clonidine to bupivacaine 0.25% in ilioinguinal-iliohypogastric nerve block prolongs postoperative analgesia in children. ⋯ Our study failed to demonstrate any advantage in addition of 1 microg.kg(-1) clonidine to 0.25% bupivacaine for ilioinguinal-iliohypogastric nerve block compared with bupivacaine 0.25% alone.