Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2013
Comparative StudyImpact of rocuronium vs succinylcholine neuromuscular blocking drug choice for laparoscopic pyloromyotomy: is there a difference in time to transport to recovery?
This study evaluates the relationship between neuromuscular blocking drug administered and transport time following laparoscopic pyloromyotomy. ⋯ For laparoscopic pyloromyotomy in term infants using propofol, sevoflurane and no intraoperative opioid, succinylcholine may be the best neuromuscular blocking drug choice, provided no contraindication is present. However, based on the small difference in time to transport, rocuronium as administered herein may be a reasonable alternative preferred by some clinicians.
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Following a propofol anesthetic, a 5-year-old girl with lower extremity spasticity seized and developed hypertriglyceridemia, hyperkalemia, and metabolic acidosis. A presumed diagnosis of propofol infusion syndrome (PRIS) was made, but further investigation revealed neonatal adrenoleukodystrophy. PRIS should be considered with this constellation of symptoms, but other neurometabolic disorders must always be ruled out.
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Paediatric anaesthesia · Apr 2013
Anesthetic implications of infants with mandibular hypoplasia treated with mandibular distraction osteogenesis.
To document the incidence of difficult intubation following mandibular distraction osteogenesis (MDO) in children with severe mandibular hypoplasia. ⋯ In a select group of infants with severe upper airway obstruction who have failed nonsurgical airway interventions, mandibular distraction osteogenesis reduces the incidence of difficult mask ventilation and difficult intubation. We were not able to compare the improvement in airway management to a comparable group of PRS infants who did not undergo surgical intervention. The improvement in laryngeal view was most marked for infants with isolated PRS but no significant benefit was demonstrated in infants with TCS.