Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2010
Spinal needle design and size affect the incidence of postdural puncture headache in children.
In adults, pencil point spinal needles are known to be less traumatic and hence to be superior compared with cutting point needles in respect of postpuncture complications. In children, only a few trials have evaluated the difference in the incidence of postdural puncture headache (PDPH) using spinal needles with different tip designs. The aim of this study was to evaluate the success rate and the incidence of PDPH and backache following spinal anesthesia (SA) with the two types of needles currently in use for children. ⋯ The data suggest that 27G pencil point spinal needles lead to less PDPH compared to 26G cutting point spinal needles in children.
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Paediatric anaesthesia · Feb 2010
Nurse-controlled analgesia (NCA) following major surgery in 10,000 patients in a children's hospital.
Patients who received NCA with morphine following major surgery between 1996 and 2008 at Great Ormond Street Hospital, London, UK, were prospectively studied in the postoperative period to determine effectiveness, morphine requirements, incidence of common side effects, and serious adverse events. ⋯ NCA with morphine is an acceptable, safe, and effective method of postoperative analgesia for a wide range of ages and types of surgery in our practice. Morphine requirements increase with age, but there was also considerable inter-individual variation within age groups. PONV, itching, sedation, and respiratory depression are expected side effects. SAE are uncommon but the incidence is greatest in neonates.