Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2009
Hyperthermia in the pediatric intensive care unit--is it malignant hyperthermia?
To determine the characteristics of calls made to the Malignant Hyperthermia Association of the United States (MHAUS) Hotline regarding pediatric patients in the intensive care unit setting. ⋯ Cases of elevated temperature in children in an intensive care unit setting reported to the MHAUS Hotline were rarely considered to be MH related. Although MH does not represent a significant portion of diagnoses related to hyperthermia, when hyperthermia occurs in children exposed to anesthetic agents, MH should be considered in the differential diagnosis.
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Paediatric anaesthesia · Nov 2009
Randomized Controlled TrialEpinephrine test dose in children: is it interpretable on ECG monitor?
Epidural and other regional blocks are performed in children under general anesthesia; the response to a 'test dose' may be altered during administration of general anesthetics. Limited data is available describing changes in electrocardiogram, blood pressure and heart rate (HR) following unintentional intravascular injection of a lidocaine-epinephrine-containing test dose, under sevoflurane anesthesia in children. ⋯ An increase in T-wave amplitude can easily be detected by carefully observing the ECG monitor or an ECG printout within a minute following the accidental i.v. administration of 0.1 ml x kg(-1) of 1% lidocaine-epinephrine (0.5 microg x kg(-1)) regional anesthetic test dose in children under sevoflurane anesthesia.
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Paediatric anaesthesia · Nov 2009
Meta AnalysisDexmedetomidine pharmacokinetics in pediatric intensive care--a pooled analysis.
Published dexmedetomidine pharmacokinetic studies in children are limited by participant numbers and restricted pathology. Pooling the available studies allows investigation of covariate effects. ⋯ The sedation target concentration is similar to that described for adults. Immature clearance in the first year of life and a higher clearance (when expressed as l x h(-1) x kg(-1)) in small children dictate infusion rates that change with age. Extrapolation of dose from children given infusion in intensive care after cardiac surgery may not be applicable to those sedated for noninvasive procedures out of intensive care.
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Paediatric anaesthesia · Nov 2009
Randomized Controlled Trial Comparative StudyEfficacy of a low-dose spinal morphine with bupivacaine for postoperative analgesia in children undergoing hypospadias repair.
Children undergoing hypospadias repair need to be protected from highly unpleasant sensory and emotional experiences during and after surgery. We designed a double-blinded, randomized, and placebo-controlled study to compare the efficacy of a low-dose (2 microg x kg(-1)) of intrathecal morphine with placebo for postoperative pain control of children undergoing repair of hypospadias surgery with spinal anesthesia. ⋯ Spinal anesthesia provided by hyperbaric bupivacaine is adequate for distal hypospadias repair in children, but adding 2 microg x kg(-1) intrathecal morphine provides better postoperative pain control when compared to placebo in these children.