Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1995
Preoperative evaluation of the cervical spine in children with trisomy-21: results of a questionnaire study.
Atlantoaxial subluxation (AAS) is a form of cervical spine instability predominantly found in persons with Trisomy-21. Several case reports describe the occurrence of acute AAS in the perioperative period. Some authors have recommended cervical spine radiographs prior to elective surgery in all children with Trisomy-21. ⋯ Approximately half of the respondents would attempt to maintain the head and neck in a neutral position for either asymptomatic (42%) or symptomatic (55%) patients. We conclude that the majority of respondents base their preoperative evaluation of the cervical spine on the signs and symptoms of the patient. This is supported by the literature reviewed, but is contrary to the recommendations made in some case reports.
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Paediatric anaesthesia · Jan 1995
CRIES: a new neonatal postoperative pain measurement score. Initial testing of validity and reliability.
We have developed a neonatal pain assessment tool CRIES. The tool is a ten point scale similar to the APGAR score (Apgar 1953). It is an acronym of five physiological and behavioural variables previously shown to be associated with neonatal pain. ⋯ We have tested CRIES for validity and reliability. This report is the result of that testing. We have found CRIES to be valid, reliable and well accepted by neonatal nurses.
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Paediatric anaesthesia · Jan 1995
Case ReportsThe laryngeal mask airway for fibreoptic bronchoscopy in children.
A size 2 laryngeal mask airway (ID 7 mm) was used for general anaesthesia during fibreoptic bronchoscopy in a six-year-old child. The mask permitted the use of an adult bronchoscope with an external diameter of 5 mm. Throughout bronchoscopy, adequate controlled ventilation could be achieved easily without excessive air leak or airway resistance; the Spo2 was always > 97%, and the end-tidal Pco2 ranged between 3.9-4.5 kPa (30-35 mmHg).
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Paediatric anaesthesia · Jan 1995
Case ReportsAnaesthetic management of the child with myotonic dystrophy: epidural anaesthesia as an alternative to general anaesthesia.
An 11-year-old boy with myotonic dystrophy required anaesthesia for a lower extremity orthopaedic procedure. The management of patients with myotonic dystrophy is discussed including the use of epidural anaesthesia with a continuous chloroprocaine infusion as an alternative to general anaesthesia.
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Paediatric anaesthesia · Jan 1995
A survey of interhospital transport of the critically ill child in the United Kingdom.
Nineteen paediatric intensive care units were surveyed by questionnaire to provide information on the number of interhospital transfers, the experience of personal accompanying the critically ill child and the equipment available to maintain intensive care during transfer. Replies were received from 17 units. ⋯ Most respondents believed that existing arrangements for transfer were unsatisfactory, but only four units said that transfer may be prevented or delayed by lack of facilities. We believe that any plan to centralize paediatric intensive care in the UK should also include the means by which to transfer the patient without increasing the risk to the patient.