Paediatric anaesthesia
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Paediatric anaesthesia · May 2013
Comparative StudyNebulized lidocaine alone or combined with fentanyl as a premedication to general anesthesia in spontaneously breathing pediatric patients undergoing rigid bronchoscopy.
Pediatric bronchoscopy is an intensely stimulating procedure that requires a deep level of anesthesia to prevent hemodynamic overstimulation and straining. Topical anesthesia of the airway may be a beneficial component of the anesthetic technique to achieve adequate depth without residual sedation. Experimental evidence suggests that in addition to its central effects, locally applied opioids elicit potent analgesic effects. ⋯ It is concluded that preoperative nebulized fentanyl reduces the hemodynamic response to bronchoscopy and decreases the intraoperative coughing in response to surgical manipulation without significant side effects except prolonged time to full wakefulness of patients.
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Paediatric anaesthesia · May 2013
Randomized Controlled TrialA randomized study of surgical site infiltration with bupivacaine or ketamine for pain relief in children following cleft palate repair.
Wound infiltration with ketamine reduces postoperative pain after tonsillectomy by NMDA receptor blockade and local anesthetic effect. ⋯ Surgical site infiltration with either bupivacaine or ketamine provides adequate analgesia and is devoid of major side effects. Ketamine is superior to bupivacaine in terms of requirement of rescue analgesic, peaceful sleep pattern and early resumption of feeding.
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Paediatric anaesthesia · May 2013
Letter Case ReportsAnesthesia for a child with Camurati-Engelmann disease.
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Paediatric anaesthesia · May 2013
Case ReportsPneumoperitoneum for neonatal laparoscopy: how safe is it?
We present the case of a 3 day old term neonate who experienced a cardiopulmonary arrest during creation of pneumoperitoneum for laparoscopic repair of duodenal atresia. The arrest was thought likely to have occurred as a result of a gas embolism. We discuss the features of the neonatal circulation which may predispose neonates to embolic phenomena during laparoscopic procedures, and the potential benefit of priming the insufflation apparatus with carbon dioxide. The possibility of gas embolism should be considered when contemplating laparoscopic surgery in this patient group.