Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2007
Randomized Controlled Trial Comparative StudyProcedural sedation for insertion of central venous catheters in children: comparison of midazolam/fentanyl with midazolam/ketamine.
There is a lack of studies evaluating procedural sedation for insertion of central venous catheters (CVC) in pediatric patients in emergency departments or pediatric intensive care units (PICU). This study was designed to evaluate whether there is a difference in the total sedation time for CVC insertion in nonintubated children receiving two sedation regimens. ⋯ In this study of nonventilated children in PICU undergoing central line placement, M/F and M/K provided a clinically comparable total sedation time. However, the M/K sedation regimen was associated with a higher rate of minor complications. A longer period of study is required to assess the efficacy and safety of these sedative agents for PICU procedures in nonintubated children.
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Paediatric anaesthesia · Apr 2007
Development and preliminary psychometric testing of the Multidimensional Assessment of Pain Scale: MAPS.
This study aimed to test the preliminary psychometric properties of the Multidimensional Assessment Pain Scale (MAPS), a clinical instrument developed for assessing postoperative pain in critically ill preverbal children. ⋯ Although initial psychometric testing of the MAPS shows promising results, the tool requires further psychometric testing, including responsiveness to analgesic effect (currently in progress).
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Paediatric anaesthesia · Apr 2007
Case ReportsA combination of total intravenous anesthesia and thoracic epidural for thymectomy in juvenile myasthenia gravis.
Juvenile myasthenia gravis is the acquired form of the disease in children and presents with ocular signs, fatigability, weakness and bulbar problems. The majority of patients demonstrate thymic hyperplasia and have been shown to benefit from thymectomy. ⋯ Two cases of thymectomy are presented where anesthesia was provided using a combination of TIVA and thoracic epidural analgesia. Both patients tolerated the technique well and had an uncomplicated perioperative course.
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Paediatric anaesthesia · Apr 2007
Randomized Controlled TrialMidazolam does not reduce emergence delirium after sevoflurane anesthesia in children.
Behavioral disturbance in children following sevoflurane anesthesia is a relatively frequent event. The aim of this study was to evaluate whether a higher dose of preoperatively administered rectal midazolam compared with a lower would alleviate this phenomenon. Furthermore the impact of these two doses of midazolam on sedation at induction of anesthesia was compared. ⋯ A higher dose of 1 mg.kg(-1) rectal midazolam results in much better sedated children on induction of anesthesia than 0.5 mg.kg(-1). This, however, does not result in a reduced incidence of emergence delirium after sevoflurane anesthesia. Regardless of the premedication negative behavioral changes occur more frequently in children younger than 3 years of age.