Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2007
Case ReportsMinor increase of endtidal CO2 during sevoflurane-induced malignant hyperthermia.
Malignant hyperthermia (MH) in a pediatric patient during sevoflurane anesthesia with only a minor rise of endtidal CO(2) is described. MH was considered because of increased rectal temperature. ⋯ In vitro contracture tests were performed on muscle biopsies from both parents. A strong contracture in response to halothane confirmed the father's MH susceptibility, thereby according a high probability of an MH episode in his son.
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Paediatric anaesthesia · Feb 2007
Randomized Controlled Trial Comparative StudyA comparison of bilateral infraorbital nerve block with intravenous fentanyl for analgesia following cleft lip repair in children.
The efficacy of analgesia with bilateral infraorbital nerve block and intravenous (i.v.) fentanyl were compared for cleft lip surgery in children. ⋯ Bilateral infraorbital block is superior to fentanyl in terms of analgesia, and time to awakening and feeding.
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Paediatric anaesthesia · Feb 2007
Risk factors for adverse events in children with colds emerging from anesthesia: a logistic regression.
Recent upper respiratory infection (URI) in children increases respiratory adverse events following anesthesia for elective surgery. The increased risk continues weeks after resolution of acute URI symptoms. Few systematic analyses have explored specific risk factors. This logistic regression explores the relationship between preoperative URI symptoms and adverse events during emergence from anesthesia. ⋯ Specific preoperative symptoms were not useful in predicting respiratory adverse events during emergence from anesthesia.
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Paediatric anaesthesia · Feb 2007
Clinical TrialA pilot study of inhaled methoxyflurane for procedural analgesia in children.
Methoxyflurane (MF), a potent volatile anesthetic, can be used as an analgesic in subanesthetic concentrations. In Australia, MF is extensively used in children and adults as an analgesic in the prehospital setting via a hand-held inhaler device. We conducted a pilot study to explore its use as a patient controlled analgesic for painful procedures in children in the emergency department (ED). ⋯ On the basis of this small pilot study of MF use in children in the ED, this agent appears to be a powerful analgesic. MF seems most useful as a self-titrated bridging analgesic agent in patients after extremity trauma. It appears less useful as a procedural agent when patients are unable to anticipate and achieve a sufficient level of analgesia before painful stimulus infliction. Pre- and intraprocedure coaching is an important aspect of its use especially if initial pain scores are low.
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Paediatric anaesthesia · Feb 2007
Clinical TrialRopivacaine spinal anesthesia in neonates: a dose range finding study.
Our primary aim was to determine the minimum local anaesthetic dose (MLAD) defined as the median effective local anesthetic dose for spinal anesthesia in neonates. Secondary aims were to determine the dose-response curve for spinal anesthesia including the clinically relevant ED95 dose and to describe the duration of motor block following ropivacaine spinal anesthesia. ⋯ Ropivacaine is an effective agent for spinal anesthesia in neonates at a recommended dose of 1.08 mg.kg(-1). The motor block duration, however, is significantly shorter than equivalent agents and highly variable in duration.