Paediatric anaesthesia
-
Paediatric anaesthesia · Apr 2006
Case ReportsUse of BIS monitor in a child with congenital insensitivity to pain with anhidrosis.
We describe a case of a 14-year-old boy with congenital insensitivity to pain and anhidrosis (CIPA) who underwent tarsal tunnel release for tarsal tunnel syndrome. Because of abnormal pain perception, the patient's response to normally painful surgical stimuli is severely impaired and not adequately reflected in a corresponding rise in blood pressure or heart rate. This lack of autonomic feedback to pain stimuli may make it more difficult to assess whether anesthetic depth is adequate to prevent intraoperative awareness and thus to safely conduct anesthesia, especially if muscle paralysis is required for surgical indications. ⋯ The BIS monitor served as an adequate tool to help avoid excessive use of volatile anesthetic while assuring a processed EEG consistent with unconsciousness and amnesia. After the patient had recovered and was oriented to place and time in the recovery room, he was asked whether he remembered anything about the surgery and the presence of a breathing tube in his mouth. He denied any recall of such events.
-
Paediatric anaesthesia · Apr 2006
Comparative StudyHeating capabilities of the Hotline and Autoline at low flow rates.
At low flow rates, fluid warmers using coaxial warming tubes are superior in preventing heat loss. This laboratory investigation was performed in order to compare the heating capabilities of two coaxial fluid warmers. ⋯ Both the Hotline and the Autoline heated infusions sufficiently at low flow rates. However, the heating capability of the Hotline was superior and can further be increased at low flow rates by increasing the room temperature.
-
Paediatric anaesthesia · Apr 2006
Case ReportsManagement of congenital tracheal stenosis--using spontaneous ventilation to facilitate cardiopulmonary bypass.
We present an unusual case of an infant with life-threatening tracheal stenosis scheduled for repair utilizing cardiopulmonary bypass. After repeated attempts at intubation endtidal CO2 was absent. The child was eventually managed with spontaneous breathing sevoflurane via a facemask. The possible causes of absent endtidal CO2 after intubation are discussed.
-
Paediatric anaesthesia · Apr 2006
Case ReportsVideo assisted fiberoptic intubation for temporomandibular ankylosis.
In the era of fiberoptics, securing of the airway under general anesthesia in small children with temporomandibular joint ankylosis without a flexible pediatric fiberoptic endoscope requires considerable skill. We describe the use of an adult flexible fiberoptic laryngoscope with a video camera system to visualize the glottis from one nostril while the tracheal tube was passed from the other nostril.
-
Paediatric anaesthesia · Apr 2006
Case ReportsDelayed ventricular fibrillation following blunt chest trauma in a 4-year-old child.
A 4-year-old boy who was involved in a motor vehicle accident as a pedestrian and suffered blunt chest trauma was admitted to the emergency room. Unpredictable delayed ventricular fibrillation was diagnosed and treated successfully 2 h later. ⋯ At the same time, other possible etiologies of VF such as cardiac pathology or electrolyte and metabolic disorders had been ruled out. Thus, an etiological link between the chest trauma and the subsequent VF could not be ruled out and is in fact plausible despite the late onset.