Paediatric anaesthesia
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The intravascular migration of an endhole epidural catheter in a child is described. We suggest measures to reduce the risk of inadvertent intravenous administration of local anaesthetic and means of reducing the effects of this with particular relevance to paediatric practice.
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Paediatric anaesthesia · Jan 1999
Clinical TrialLaryngeal mask for difficult intubation in children.
We present a new intubation technique using an oral preformed tracheal tube passed through a laryngeal mask. Six patients (neonate to six months old) with craniofacial malformations of head and neck and scheduled for reconstructive plastic surgery are the basis of this report. An inhalation induction with increasing doses of halothane in oxygen while maintaining spontaneous ventilation was performed. ⋯ Once the mask was removed, the stylet was disconnected, and the 15 mm connector reattached. Our experience was that this takes about 20 to 30 s. We recommended this technique in paediatric patients in which a difficult intubation is foreseen.
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Paediatric anaesthesia · Jan 1999
Postal survey of the anaesthetic techniques used for paediatric tonsillectomy surgery.
A postal survey of anaesthetic techniques used for tonsillectomy surgery in children (age 3-16 years) was performed with particular reference to the use of the reinforced laryngeal mask airway and the use of suxamethonium. From 110 questionnaires despatched, replies were obtained from 88 consultant anaesthetists with commitments to otolaryngologic (ENT) anaesthesia (response rate 80%). ⋯ Suxamethonium was used routinely by 40 consultants (45%) for tonsillectomy surgery. Severe problems with its use had been encountered by 26 (30%) respondents
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Paediatric anaesthesia · Jan 1999
Pulmonary atelectasis during paediatric anaesthesia: CT scan evaluation and effect of positive endexpiratory pressure (PEEP).
The case series consisted of ten children, ranged in age from one to three years (median 1.8 yrs), and in body weight from 10.2 to 13.5 kg (median 11.7 kg), in ASA class 1 or 2, all without lung disease. Having undergone general anaesthesia for cranial or abdominal CT scans, the patients were studied for pulmonary morphology. The first pulmonary CT scan was taken five min after induction of general inhalational anaesthesia; preoxygenation was avoided and an intraoperative FiO2
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Paediatric anaesthesia · Jan 1999
Evaluation of the efficiency of heat and moisture exchangers during paediatric anaesthesia.
This study evaluates the efficiency of heat and moisture exchangers (HMEs) in allowing adequate humidification and warming during anaesthesia in children. Eighteen paediatric patients undergoing anaesthesia were divided into two groups: group A ten patients: infants up to 10 kg-->Hygrobaby HME; group B 8 patients: children above 10 kg-->Hygroboy HME. The following parameters were evaluated: body temperature (bT), room temperature (rT), fresh gas temperature, HME warm-up time, inspired and expired gases temperature and humidity, conserving efficiency, and duration of anaesthesia. ⋯ The conserving efficiency was good (0.93 in both groups). A positive correlation was found between efficiency and fresh gas temperature. HMEs did not meet the minimum standards for humidity and heating during anaesthesia in children, although their conserving efficiency was found to be satisfactory.