Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2008
Intraoperative gastric tonometric examinations in children and infants with a new probe, combined with measurement of the endtidal PCO2.
Important progress relating to the early prediction of postoperative complications was recently achieved through the combined use of endtidal PCO(2) (P(ET)CO(2)) and gastric tonometry. The aim of this article was to present results obtained with a new tonometric instrument, proving its feasibility and extending its use to the control of anesthetized infants and children. ⋯ The tested new probe worked very well in small children. The clinical implications of the large gaps found between P(ET)CO(2) and P(g)CO(2) values in acutely ill children and children undergoing elective operations must be investigated further.
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Paediatric anaesthesia · Jun 2008
Case ReportsProlonged sevoflurane inhalation therapy for status asthmaticus in an infant.
A 3-month-old boy with retractive breathing from his birth was scheduled for a rigid bronchoscopic examination. Anesthesia was induced and maintained with sevoflurane. The examination revealed a slight laryngomalacia which was not compatible with his severe symptom. ⋯ There have been very few reports on application of sevoflurane inhalation for such a long period in infants with bronchospasm. Moreover, measured serum fluoride concentration (24.2 micromol x l(-1)) during inhalation was well below harmful level. Sevoflurane inhalation is worth attempting and safe to treat life-threatening bronchospasm even in infants.
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Paediatric anaesthesia · Jun 2008
Case ReportsLidocaine 5% patch for localized chronic neuropathic pain in adolescents: report of five cases.
We describe a case series of five adolescents who were managed with lidocaine 5% patches for chronic localized neuropathic pain from a variety of causes with minimal adverse effects. Treatment was effective in four of five patients with only one patient complaining of minimal pain relief. 5% Lidocaine patches have been used for treatment of chronic neuropathic pain in adults and we have found this to be effective in management of localized neuropathic pain in children and adolescents.
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Paediatric anaesthesia · Jun 2008
Experience with remifentanil-sevoflurane balanced anesthesia for abdominal surgery in neonates and children less than 2 years.
Few data report remifentanil use in the neonatal population. We described here our experience with remifentanil-sevoflurane balanced anesthesia in neonates and children less than 2 years who underwent general anesthesia for abdominal surgery. ⋯ Remifentanil-sevoflurane anesthesia can be used for general anesthesia in neonates. We observed that anesthetists used lower doses of remifantanil and lower concentrations of sevoflurane in neonates compared with the older children.
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Paediatric anaesthesia · Jun 2008
Effects of head posture on the oral, pharyngeal and laryngeal axis alignment in infants and young children by magnetic resonance imaging.
Objective anatomical studies supporting the different recommendations for laryngoscopy in infants and young children are scarce. The objective of this study was to measure by magnetic resonance imaging (MRI) the consequences of head extension on the oral, pharyngeal and laryngeal axes in infants and young children. ⋯ In infants and young children, under general anesthesia and with a laryngeal mask airway in place, just a slight head extension improves alignment of the line of vision of the glottis and the laryngeal axis (narrowing of angle delta) but worsened the alignment of the pharyngeal and laryngeal axes (widening of angle beta).