Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2006
A cohort study of the incidence and risk factors for negative behavior changes in children after general anesthesia.
Hospitalization and anesthesia can have a substantial psychological impact on children, which may be manifested by negative behavioral change. The primary aims of this study were to estimate the incidence of negative behavior change postanesthesia in a large cohort of children, and to identify the possible risk factors. ⋯ Significant negative behavior change can occur in children after anesthesia. It is difficult to precisely predict in which children this will occur, however, some individual, family and procedural variables are associated with significant negative behavior change. If used, preparation should be considered according to level of surgical complexity.
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Paediatric anaesthesia · Aug 2006
Randomized Controlled TrialOral clonidine premedication reduces minimum alveolar concentration of sevoflurane for laryngeal mask airway insertion in children.
Sevoflurane is widely employed for inhalational induction in children. Clonidine deepens volatile anesthetics and reduces several types of MAC of sevoflurane. Laryngeal mask airway is a useful device for pediatric anesthesia. The aim of the current study was to determine whether oral clonidine premedication can reduce MAC of sevoflurane for an LMA insertion in children. ⋯ Oral clonidine premedication reduced the MAC (EC50) and EC95 values of sevoflurane for LMA insertion by 38% and 28%, respectively.
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Paediatric anaesthesia · Aug 2006
Rocuronium 0.3 mg x kg-1 (ED95) induces a normal peak effect but an altered time course of neuromuscular block in patients with Duchenne's muscular dystrophy.
In patients with Duchenne's muscular dystrophy (DMD) recovery from neuromuscular block is delayed. It has been assumed that this is because of a higher potency of muscle relaxants in this patient cohort. We determined the peak effect, and the time course of action of rocuronium 0.3 mg x kg(-1) (ED(95)) in DMD patients. ⋯ The similar peak effect in both groups does not confirm the thesis of rocuronium having a higher potency in DMD patients. The documented very long recovery after the ED(95) of rocuronium emphasizes the need for careful assessment of neuromuscular function in DMD patients.
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Paediatric anaesthesia · Aug 2006
Randomized Controlled TrialThe effects of caudal local anesthesia blockade on the Bispectral Index during general anesthesia in children.
Peripheral deafferentation induced by epidural or spinal anesthesia reduces the degree of cortical arousal in adults. This study aimed at determining if caudal blockade decreases the level of arousal, as measured by Bispectral Index (BIS) in unstimulated children, and to determine if this effect differed between age groups. ⋯ Caudal blockade decreased the degree of arousal, as measured by BIS, in unstimulated children aged 2-5 years. No change in arousal was detected in infants.