Paediatric anaesthesia
-
Paediatric anaesthesia · Apr 2006
Performance of a pediatric ambulatory anesthesia program--a developing country experience.
The aim of this study was to evaluate the performance of a pediatric ambulatory anesthesia program in a tertiary care teaching hospital in a developing country. ⋯ Performance of pediatric day-care anesthesia has been good in our day-care unit and we have a successful ambulatory surgery program, despite the limitations of a developing country.
-
Paediatric anaesthesia · Apr 2006
Clinical TrialPostoperative continuous intrathecal pain treatment in children after selective dorsal rhizotomy with bupivacaine and two different morphine doses.
Children undergoing selective dorsal rhizotomy (SDR) experience severe pain postoperatively; a pain related to both the extensive surgical exposure with multilevel laminectomy and nerve root manipulation. We sought to define an optimal dose of continuous intrathecal (IT) morphine and bupivacaine to treat this severe pain. The aim of this study was to compare two different concentrations of morphine in a fixed dose of bupivacaine with regard to the analgesic effect and survey if they differed in side effects. ⋯ This study shows that, compared with low-dose, the higher dose of continuous IT morphine combined with bupivacaine, significantly reduce pain score and postoperative intravenous analgesic requirements without increasing adverse effects.
-
Paediatric anaesthesia · Apr 2006
Randomized Controlled TrialEarly vs late intraoperative administration of tropisetron for the prevention of nausea and vomiting in children undergoing tonsillectomy and/or adenoidectomy.
Tropisetron is a long-acting 5HT3 receptor antagonist and was shown to be effective in the prevention of postoperative nausea and vomiting (PONV) after tonsillectomy. The aim of the study was to compare the effects of early vs late intraoperative administration of tropisetron with regard to prevention of PONV during the first 48 h after extubation. ⋯ The intraoperative time point (early vs late) of intravenous administration of a single prophylactic dose of tropisetron has no impact on the incidence of PONV during the first 48 h after tonsillectomy and/or adenoidectomy in children.
-
Advances in electroencephalogram (EEG) processing have produced new interest in measuring anesthesia using the EEG. There are a number of EEG-based anesthesia 'depth' monitors now available and their use in pediatric anesthesia is increasing. Although these monitors have been extensively studied in adults, there are relatively few studies examining their validity or use in children. ⋯ Although the outputs from these monitors do not closely represent any true physiological entity, they can be used as guides for anesthesia and in so doing have improved outcomes in adults. In older children the physiology, anatomy and clinical observations indicate the performance of the monitors may be similar to that in adults, although the clinical relevance of outcomes may be different. In infants their use cannot yet be supported in theory or in practice.
-
Paediatric anaesthesia · Apr 2006
Case ReportsSuspected malignant hyperthermia in a child with laminin alpha2 (merosin) deficiency in the absence of a triggering agent.
Malignant hyperthermia (MH) is an inherited disorder of the skeletal muscles that can be triggered by many anesthetic agents. MH has different presentations and manifestations that makes it difficult to diagnose. Patients with laminin alpha2 deficiency have never been reported to be susceptible to MH. ⋯ The episode was diagnosed using the MH clinical grading scale and responded well to prompt management with dantrolene. We conclude that patients with laminin alpha2 deficiency may be susceptible to MH, and early suspicion and rapid treatment is vital in the management of MH. Anesthesiologists should be prepared to treat MH in susceptible patients even in the absence of a classical triggering agent.