Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialPropofol infusion vs thiopentone/isoflurane anaesthesia for prominent ear correction in children.
Postoperative nausea and vomiting (PONV) frequently follows prominent ear correction under general anaesthesia in children. In a prospective, single-blind study, we compared the incidence of PONV after propofol infusion anaesthesia with that following thiopentone induction and isoflurane maintenance in 30 children aged from four to 14 years randomly allocated to one of two groups. All the children were mechanically ventilated. ⋯ One child receiving propofol (group P) complained of nausea, compared with eight receiving thiopentone/ isoflurane, (group T) (P = 0.005), while three children in group P and ten in group T vomited before hospital discharge, (P = 0.01). Eight children in group P were considered to be fit for discharge on the day of surgery as against four in group T, (not significant). Only four out of twelve children receiving opioid analgesia vomited.
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Paediatric anaesthesia · Jan 1997
Randomized Controlled Trial Clinical TrialPostoperative analgesia with preoperative oral ibuprofen or acetaminophen in children undergoing myringotomy.
Previous studies have shown over 70% of children require analgesics following bilateral myringotomy and tube placement (BM&T). This double-blind, placebo-controlled study compared the postoperative analgesic effects of preoperatively administered oral acetaminophen or ibuprofen. Forty three ASA I or II children age six months or older scheduled for elective BM&T were randomized to receive acetaminophen (paracetamol) 15 mg.kg-1, ibuprofen 10 mg.kg-1, or placebo. ⋯ CHEOP scores did not differ between the groups at any time. There was no difference in the number of children receiving rescue analgesia. This study showed no benefit of preoperatively administered oral ibuprofen 10 mg.kg-1 or acetaminophen 15 mg.kg-1 over placebo for the relief of postoperative pain in children undergoing BM&T.
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Paediatric anaesthesia · Jan 1997
Randomized Controlled Trial Clinical TrialOral premedication with midazolam in paediatric anaesthesia. Effects on sedation and gastric contents.
The aim of this study was to assess oral premedication with midazolam in paediatric anaesthesia. Sedation, quality of induction, recovery time, acceptance and effects on gastric contents were analysed. This prospective, double blind, at random and controlled study was performed in 107 children, aged between three and ten years. ⋯ The recovery time was similar for the two groups. There were no statistically significant differences in gastric pH or residual volume among the three groups. It is concluded that midazolam given by mouth is an efficient and safe drug for premedication in paediatric anaesthesia.
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Paediatric anaesthesia · Jan 1997
Para-umbilical block: a new concept for regional anaesthesia in children.
This preliminary study describes a new technique to provide analgesia in children undergoing umbilical hernia repair. The para-umbilical block consists of infiltrating the anterior cutaneous branches of the two tenth spinal roots over and under the rectus sheath far from the operative field. Intra and postoperative analgesia as well as operative conditions were assessed in 11 children 16.7 +/- 31 months old, weighing 8421 +/- 6941 g, the block being performed before surgery under light general anaesthesia. ⋯ The block proved to be safe and on the whole effective in this short series. The study should proceed on a multi-centre basis if possible. Indications can be extended.
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Paediatric anaesthesia · Jan 1997
Case ReportsBilateral continuous paravertebral block used for postoperative analgesia in an infant having bilateral thoracotomy.
We describe the successful postoperative pain management in an 11-month-old infant who underwent bilateral thoracotomy, using continuous infusions of bupivacaine into two directly placed paravertebral catheters. Haemodynamic parameters and pain scores were measured 1-2 h for 60 h while the infusions were continued and, intermittently, blood samples were taken for subsequent measurement of serum bupivacaine concentrations. ⋯ There were no adverse haemodynamic consequences or complications relating to either catheter placement or drug infusions. Serum concentrations of bupivacaine remained below toxic levels throughout the study period, though accumulation did occur.