Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2007
Case ReportsApnea in a child after oral codeine: a genetic variant - an ultra-rapid metabolizer.
We present a case of a 29 months old previously healthy child who experienced apnea resulting in brain injury following a dose of acetaminophen and codeine 2 days after an uneventful anesthetic for tonsillectomy. A genetic polymorphism leading to ultra-rapid metabolism of codeine into morphine resulted in narcosis and apnea. This paper discusses the use of codeine for pain relief, obstructive sleep apnea, the alteration of the CYP2D6 gene and the resulting effect on drug metabolism.
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Paediatric anaesthesia · Jul 2007
Case ReportsBispectral index monitored balanced anesthesia technique for pheochromocytoma resection.
Balanced anesthesia under bispectral index monitoring was administered to a child undergoing a pheochromocytoma resection. By titration of anesthesia depth, the stress response during resection could be avoided as well as postresection hypotension, without resort to additional pharmacological manipulation.
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Paediatric anaesthesia · Jun 2007
Randomized Controlled TrialCardiac rhythm and left ventricular function of infants at 1 MAC sevoflurane and halothane.
The implementation of sevoflurane in pediatric anesthesia practice led to a decrease in the incidence of cardiac arrest previously reported with halothane. Nevertheless, the effects of sevoflurane on cardiac rhythm and function have not been systematically investigated in infants. Thus, we compared cardiac rhythm and left ventricular function at 1 MAC sevoflurane and halothane anesthesia and investigated the potential benefit effect of atropine. ⋯ Indices of left ventricular function were comparable between groups with no clinically significant change following atropine administration. The present study confirms the favorable hemodynamic profile of sevoflurane in infants breathing spontaneously at 1 MAC concentration.