Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2007
Case ReportsProlonged retrograde amnesia following sedation with propofol in a 12-year-old boy.
Propofol is commonly used for sedation in a variety of clinical settings, as well as for induction and maintenance of anesthesia. The ease with which propofol can be administered and titrated to clinical effect, in addition to its accepted safety profile, has made it the drug of choice for sedation in outpatient procedures, such as gastrointestinal endoscopy. While short-term amnesia is a well-known side-effect of propofol, we present the first documented case of prolonged retrograde amnesia following propofol administration in a pediatric patient. Possible mechanisms and clinical management strategies related to this unique event are discussed.
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Paediatric anaesthesia · Apr 2007
Randomized Controlled Trial Comparative StudyProSeal as an alternative to endotracheal intubation in pediatric laparoscopy.
The increasing use of laparoscopic surgery in children mandates a leak-free airway device during carboperitoneum for which tracheal tubes (TT) have been traditionally used. The pediatric ProSeal is a recent introduction to the laryngeal mask airway (LMA) family. The ProSeal LMA (PLMA) has been successfully used in adult laparoscopic procedures. We hypothesized that the ProSeal can be equally effective in achieving adequate oropharyngeal seal and pulmonary ventilation during elective laparoscopic procedures in children. ⋯ The pediatric PLMA and TT have comparable ventilatory efficacy for elective short laparoscopic procedures.
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Paediatric anaesthesia · Apr 2007
Case ReportsAdjunct continuous intravenous ketamine infusion for postoperative pain relief following posterior spinal instrumentation for correction of scoliosis: a case report.
Providing effective analgesia is challenging for correction of idiopathic scoliosis, as nonsteroidal anti-inflammatory drugs and epidural anesthesia are controversial and large-dose opioids can cause significant side effects. Perioperative adjuvant low-dose ketamine has been shown to provide good supplementary analgesia as well as to potentially spare opioid consumption. Ketamine may also improve early ease of mobility without addition of any noticeable adverse effects. ⋯ The patient had excellent postoperative analgesia and was able to participate in early rehabilitation. The opioid-sparing effect of ketamine was not demonstrated in this case. Further study of continuous low-dose ketamine infusions in this patient population would be beneficial to provide more evaluation of the efficacy and tolerability of ketamine and of its opioid-sparing potential.
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Paediatric anaesthesia · Apr 2007
Clinical TrialChanges of bispectral index during recovery from general anesthesia with 2% propofol and remifentanil in children.
The bispectral (BIS) index is a pharmacodynamic measure of the effect of anesthesia on the central nervous system. The aim of this study was to investigate the relationship between BIS index and predicted plasma concentration of propofol delivered by target controlled infusion (TCI) during emergence in children. ⋯ In preschool children, BIS moderately correlated with the predicted plasma concentration of propofol.
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Paediatric anaesthesia · Apr 2007
Clinical TrialDexmedetomidine for the treatment of postanesthesia shivering in children.
Shivering is a common postanesthesia adverse event with multiple etiologies and multiple suggested prophylactic and abortive treatment regimens. Dexmedetomidine, a centrally acting alpha(2)-adrenergic agonist, has been used as a sedative agent and is known to reduce the shivering threshold. We hypothesized that children with postanesthesia shivering would reduce shivering behavior following a single bolus dose of dexmedetomidine. ⋯ This study demonstrates the efficacy of dexmedetomidine in the treatment of postanesthesia shivering.