Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2007
Case ReportsUnilateral postoperative visual loss due to central retinal artery occlusion following cervical spine surgery in prone position.
Postoperative visual loss following spinal surgery is a rare complication. Although a number of intraoperative and postoperative factors have been implicated exact etiology still may remain unclear. We report a case of unilateral postoperative visual loss in a patient who had undergone prolonged spine surgery in a prone position.
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Paediatric anaesthesia · Aug 2007
ReviewA qualitative systematic review of morphine treatment in children with postoperative pain.
Postoperative pain management in children is often empirical rather than evidence based. Morphine is the pharmacological treatment most widely used and although considered safe for children, adequate scientific data on morphine's pharmacokinetics, efficacy and safety are lacking. This systematic review aimed to evaluate the available literature examining different pediatric morphine regimens with respect to dosage, analgesic efficacy and incidence of side effects. ⋯ Although several factors may justify its use as first line therapy in many parts of the world, morphine alone is not the most suitable analgesic for postoperative pain in pediatric patients, as it does not have superior analgesic effect and a higher incidence of side effects compared with active control interventions. More standardized clinical trials with multimodal regimens as well as guidelines for evaluating pediatric medicines are desirable in the future.
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Paediatric anaesthesia · Aug 2007
Randomized Controlled TrialA ketamine-propofol admixture does not reduce the pain on injection compared with a lidocaine-propofol admixture.
Propofol injection pain is a well-known problem in pediatric anesthesia. Premixture of lidocaine with propofol although effective does not abolish injection pain in all children. Promising results have been reported with pretreatment of the vein with ketamine. The purpose of this prospective, double-blind randomized, clinical trial with active control was to evaluate the efficacy of premixing propofol with ketamine in the prevention of injection pain in children. ⋯ Injection pain was twice as common with ketamine-propofol admixture than with lidocaine-propofol admixture.