Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2007
Case ReportsAnesthesia for repair of gastroschisis in thoracopagus twins: a case report.
The first pair of live conjoined twins in Fiji were delivered in June 2004. Their union was unexpected and in addition they had gastroschisis requiring urgent surgery. With limited resources available there was uncertainty about the degree of sharing of the major organs. ⋯ Surgical repair of the abdominal defect was performed using a combined general and regional anesthesia technique. The thoracopagus twins died 3 days postoperatively in the Neonatal Intensive Care Unit. Perioperative management is discussed.
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A 10-year-old boy fell from a tree and sustained blunt injury to his chest. He was brought to the hospital (6 h later) with difficulty in breathing and inability to speak. There was a bruise on the neck and extensive subcutaneous emphysema over the neck and chest and decreased air entry over the right hemithorax. ⋯ This followed the ureteric catheter into the distal trachea and the trachea was successfully cannulated. We review the mechanism of tracheal injuries with special reference to its occurrence in children with blunt injury. We discuss the airway management in these potentially life-threatening injuries.
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Paediatric anaesthesia · Mar 2007
Use of the ASA Physical Status Grading System in pediatric practice.
The American Society of Anesthesiologists (ASA) Grading System is widely used to describe preoperative physical status. Inconsistency of grading between anesthetists has been demonstrated in studies using hypothetical adult patient scenarios. We aimed to investigate the use and interrater reliability of the ASA Grading System in pediatric anesthesia practice. ⋯ The ASA Grading System shows poor interrater reliability in pediatric practice, as it does in adults. This should be borne in mind when using the ASA System for clinical or scientific work in pediatrics. A physical status grading system developed specifically for use in pediatrics may reduce inconsistency.
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Paediatric anaesthesia · Mar 2007
Ambulatory anesthesia and the lack of consensus among Canadian pediatric anesthesiologists: a survey.
The purpose of this study was to assess the current selection criteria for outpatient surgery in children among Canadian pediatric anesthesiologists. ⋯ Further studies are needed to establish evidence-based medicine to support guidelines that would allow one to select children safely for ambulatory surgery.
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Paediatric anaesthesia · Mar 2007
Case ReportsCardiac arrest in a child with cerebral palsy undergoing sevoflurane induction of anesthesia after preoperative clonidine.
Clonidine is a frequently administered alpha2-adrenergic agonist which can decrease heart rate and blood pressure. We present a case of a 5-year-old child with cerebral palsy and seizure disorder, receiving clonidine for restlessness, who presented for placement of a baclofen pump. ⋯ During induction of anesthesia, the patient developed bradycardia and hypotension requiring cardiac resuscitation. There are no previous reports of clonidine-associated cardiac arrest in a child undergoing induction of anesthesia.