Paediatric anaesthesia
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The use of propofol infusions to sedate children in intensive care units has decreased after reports of deaths from myocardial failure. More recently it has been suggested that propofol might have been prematurely condemned. Information about 18 children who had received propofol infusions and suffered serious unwanted effects was used to define their common features. ⋯ During this period 44 children with respiratory tract infections had been admitted to this unit and sedated for at least 48 h. Nine had received long-term (> 48 h), high-dose (> 4 mg.kg-1.h-1) propofol infusions and three had developed progressive myocardial failure and died. There was a significant association between receiving a long-term, high-dose propofol infusion and developing progressive myocardial failure (Fisher's Exact Test, two-tailed hypothesis, P = 0.0128) although a causative relationship could not be proved.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Comparative Study Clinical TrialProphylactic therapy with granisetron in the prevention of vomiting after paediatric surgery. A randomized, double-blind comparison with droperidol and metoclopramide.
The antiemetic efficacy of droperidol, metoclopramide and granisetron was compared with placebo in the reduction of vomiting after paediatric surgery (the extremities; inguinal hernia; and phimosis) during general inhalational anaesthesia. One hundred children, ASA physical status I, 4-10 years of age, were enrolled in a prospectively, randomized, double-blind investigation and assigned to one of four treatment regimens: placebo (saline, n = 25), droperidol (50 micrograms.kg1, n = 25), metoclopramide (0.25 mg.kg-1, n = 25) or granisetron (40 micrograms.kg-1, n = 25). ⋯ The incidence of adverse events postoperatively was not different among the treatment groups. In conclusion, granisetron 40 micrograms.kg-1 is a better antiemetic than droperidol and metoclopramide when compared to placebo for the prevention of postoperative emesis in children.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Comparative Study Clinical TrialRopivacaine in paediatric surgery: preliminary results.
In a double blind study 40 patients, aged 1-9 years, undergoing elective minor surgery were examined and randomly divided in two groups (20 children each). After light general anaesthesia Group 1 received caudal injection of bupivacaine 0.25% 2 mg.kg-1 while Group 2 received 0.2% ropivacaine 2 mg.kg-1. ⋯ No motor block was apparent at awakening in either group and no side effect was noticed. In conclusion ropivacaine seems to be an effective and safe drug in paediatric regional anaesthesia.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Comparative Study Clinical TrialA double blind comparison of droperidol and ondansetron for prevention of emesis in children undergoing orthopaedic surgery.
Emesis is common in the postoperative period following epidural opioid and general anaesthesia. Eighty patients ages two to 14 years scheduled for major orthopaedic surgery were enrolled in a randomized, double-blind study to compare the prophylactic effects of ondansetron, droperidol and a placebo for the prevention of postoperative emesis. Each child was assigned at random to one of the four treatment groups: ondansetron 100 micrograms.kg-1, ondansetron 50 micrograms.kg-1, droperidol 60 micrograms.kg-1 and saline control. ⋯ Ondansetron (50 micrograms.kg-1) and droperidol groups had lower incidence of PONV compared to the control group. The ondansetron (100 micrograms.kg-1) group had a significant decrease in the incidence of emesis. We conclude that the prophylactic administration of ondansetron (100 micrograms.kg-1) is more effective than droperidol and ondansetron (50 micrograms.kg-1) and superior to saline (P < 0.02) for the prevention of emesis before epidural opioid and general anaesthesia.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Clinical TrialConvective warming blankets improve peroperative heat preservation in congenital heart surgery.
Peroperative heat preservation, following hypothermic cardiopulmonary bypass (CPB) in children, has always been a challenge to the anaesthetist. We studied the efficiency of a convective heating system on peroperative heat preservation in 50 children undergoing congenital heart surgery. Twenty-five children, rewarmed by CPB and heating mattress, were randomly selected (Group 1). ⋯ At the end of bypass there was no significant difference between the two groups. At the end of operation the central and peripheral temperatures were significantly higher in Group 2. In conclusion convective warming blankets are effective in keeping or even raising the temperature following congenital heart surgery.