Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1999
Letter Case ReportsResistance to vecuronium after immobilization.
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Paediatric anaesthesia · Jan 1999
Case ReportsUse of the laryngeal mask airway during repair of atrial septal defect in children.
We describe the elective use of the laryngeal mask airway in two children undergoing cardiopulmonary bypass for repair of an atrial septal defect. Total surgical time was short and cardiopulmonary bypass performed at normothermia allowing removal of the laryngeal mask airway on the operating table on completion of surgery. ⋯ Atrial septal defect repair has become one of the more straightforward cardiac operations partly as a result of new cardiopulmonary bypass techniques. Avoidance of intubation and postoperative ventilation in appropriate patients would make this procedure ideal for 'fast tracking' and offers the potential advantages of decreased length of stay in hospital and reduction in overall costs.
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Paediatric anaesthesia · Jan 1999
Case ReportsUnintentional paediatric subdural catheter with oculomotor and abducens nerve palsies.
A 13-year-old female with a past history of lumbar laminectomy developed a subdural block 18 h after the commencement of an epidural infusion of bupivacaine 0.125% and fentanyl 2 micrograms.ml-1. Signs at presentation included bilateral abducens nerve palsies in the absence of headache and a previously unreported unilateral third cranial nerve palsy. An epidurogram displayed subdural placement.
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Paediatric anaesthesia · Jan 1999
Case ReportsReturn of the internal jugular vein--development of collateral drainage following neonatal ligation of the vein.
The development of collateral venous drainage in the neck of a child, who as a neonate had undergone ligation and cannulation of the right internal jugular vein, is described. The resultant vessels were of sufficient calibre to be considered as potential sites for vascular access, although it is possible that their course in the thorax may preclude correct placement of a central venous catheter. Nevertheless, we feel that this case further illustrates the benefit of hand-held ultrasonography in visualizing the vascular structures of the neck. Moreover, ligation of a vein in the neonatal period should not be a contraindication to subsequent assessment of that site for vascular access.