Paediatric anaesthesia
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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
Randomized Controlled Trial Comparative Study Clinical TrialThe analgesic efficacy of an injectable prodrug of acetaminophen in children after orthopaedic surgery.
The analgesic efficacy and safety of propacetamol, an injectable prodrug of acetaminophen, (paracetamol) were studied in 87 children (36 boys, 51 girls; age 6-13; mean age 9.5 years) immediately after limb surgery. Using a double-blind, randomized, parallel group design, the effects of a single IV infusion of 30 mg.kg-1 propacetamol (i.e. 15 mg.kg-1 acetaminophen) were compared with a single injection of placebo (PL). ⋯ Propacetamol was statistically superior to placebo on all assessment criteria. Seven side-effects were recorded: five in the propacetamol group and two in the placebo group. 30 mg.kg-1 propacetamol provided a significantly greater analgesic effect than placebo in children after orthopaedic surgery.
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Paediatric anaesthesia · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of awakening and recovery characteristics following anaesthesia with nitrous oxide and halothane fentanyl or both for brief outpatient procedures in infants.
This study compared recovery characteristics and postoperative ventilatory function when halothane, fentanyl or combination of halothane and fentanyl in addition to N2O were used for intraoperative anaesthesia in term infants undergoing hernia repair as outpatients. Sixty-six full term ASA PS I infants ages 1-12 months were studied. All received inhalation induction with N2O, O2 and halothane, followed by intravenous atropine and atracurium, tracheal intubation, and controlled ventilation. ⋯ SpO2 < 90% and TcCO2 > 9 kPa (70 mmHg) was more common in infants receiving 2 and 10 micrograms.kg-1 fentanyl than in infants receiving halothane and nitrous oxide anaesthesia. Infants < 3 months old did not have a higher incidence of SpO2 < 90% or significantly higher TcCO2 values when compared to infants > 3 months old. Fentanyl in doses used in this study did not prolong awakening time but did prolong recovery and discharge times in outpatient infants.
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Paediatric anaesthesia · Jan 1997
Comparative Study Clinical Trial Controlled Clinical TrialPlasma bupivacaine levels after fascia iliaca compartment block with and without adrenaline.
Twenty children undergoing unilateral surgery on the thigh received a fascia iliaca compartment block using 2 mg.kg-1 of bupivacaine with (Group A) or without (Group P) adrenaline 1/200,000. Venous blood samples were taken as 5, 10, 15, 20, 25, 30, 40, 50 and 60 min after injection and assayed for concentrations of bupivacaine. In all subjects an adequate block was produced. ⋯ The median time to first analgesia was 9.75 h (range 3-15 h) in Group P and 10.5 h (range 2.5-21 h) in Group A. The study confirmed the efficacy of the fascia iliaca compartment block in children and showed that when performed with 2 mg.kg-1 of bupivacaine it is associated with plasma concentrations of bupivacaine well within acceptable limits. The addition of adrenaline 1/200,000 to the local anaesthetic solution reduces the maximum plasma concentration reached.
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Paediatric anaesthesia · Jan 1997
Randomized Controlled Trial Clinical TrialIntermittent positive ventilation through a laryngeal mask in children: does it cause gastric dilatation?
After obtaining Ethics Committee approval and informed consent, sixty children, ASA Grade 1 or 2 and aged six months to ten years, were randomly allocated to receive intermittent positive pressure ventilation through either a laryngeal mask or a tracheal tube. Inflation pressures were maintained below 20 cm H2O, and gas aspirated from the stomach via an orogastric tube over a one h period. No large volumes were aspirated and no differences were detected between the groups. We conclude that healthy children over the age of six months can be safely ventilated through the laryngeal mask airway without gastric distension.