Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1999
ReviewPaediatric head injury: incidence, aetiology and management.
Trauma is the commonest cause of hospital admission in children. Head injuries are present in 75% of children with trauma and 70% of all traumatic deaths are due to the head injury. ⋯ Therapeutic interventions will be discussed with specific emphasis on outcome studies. However, institution of adequate oxygen delivery and haemodynamic stability in the child at the earliest moment remains the most important aspect of the management plan.
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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
Case ReportsThe epidural dorsomedian septum as a possible cause for unilateral anaesthesia in an infant.
Unilateral epidural anaesthesia occurring in an infant is reported. An epidurogram revealed the presence of a midline structure suggestive of the dorsomedian septum. Epidural anatomy is reviewed and implications for threading epidural catheters in infants are discussed.
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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=0.4 was used. ⋯ After ventilation with PEEP of 5 cmH2O, all the observed densities disappeared without impairment of heart rate, blood pressure, haemoglobin saturation and endtidal CO2 (PECO2). We conclude that the appearance in children of atelectasis cannot be explained by a reabsorption of O2 mechanism and by denitrogenation. However, a PEEP of 5 cmH2O is able both to recruit all the available alveolar units, and to induce the disappearance of atelectasis in dependent lung regions.