Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2007
Development and preliminary psychometric testing of the Multidimensional Assessment of Pain Scale: MAPS.
This study aimed to test the preliminary psychometric properties of the Multidimensional Assessment Pain Scale (MAPS), a clinical instrument developed for assessing postoperative pain in critically ill preverbal children. ⋯ Although initial psychometric testing of the MAPS shows promising results, the tool requires further psychometric testing, including responsiveness to analgesic effect (currently in progress).
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Paediatric anaesthesia · Apr 2007
Case ReportsA combination of total intravenous anesthesia and thoracic epidural for thymectomy in juvenile myasthenia gravis.
Juvenile myasthenia gravis is the acquired form of the disease in children and presents with ocular signs, fatigability, weakness and bulbar problems. The majority of patients demonstrate thymic hyperplasia and have been shown to benefit from thymectomy. ⋯ Two cases of thymectomy are presented where anesthesia was provided using a combination of TIVA and thoracic epidural analgesia. Both patients tolerated the technique well and had an uncomplicated perioperative course.
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Paediatric anaesthesia · Apr 2007
Randomized Controlled TrialMidazolam does not reduce emergence delirium after sevoflurane anesthesia in children.
Behavioral disturbance in children following sevoflurane anesthesia is a relatively frequent event. The aim of this study was to evaluate whether a higher dose of preoperatively administered rectal midazolam compared with a lower would alleviate this phenomenon. Furthermore the impact of these two doses of midazolam on sedation at induction of anesthesia was compared. ⋯ A higher dose of 1 mg.kg(-1) rectal midazolam results in much better sedated children on induction of anesthesia than 0.5 mg.kg(-1). This, however, does not result in a reduced incidence of emergence delirium after sevoflurane anesthesia. Regardless of the premedication negative behavioral changes occur more frequently in children younger than 3 years of age.
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Paediatric anaesthesia · Apr 2007
Case ReportsProlonged retrograde amnesia following sedation with propofol in a 12-year-old boy.
Propofol is commonly used for sedation in a variety of clinical settings, as well as for induction and maintenance of anesthesia. The ease with which propofol can be administered and titrated to clinical effect, in addition to its accepted safety profile, has made it the drug of choice for sedation in outpatient procedures, such as gastrointestinal endoscopy. While short-term amnesia is a well-known side-effect of propofol, we present the first documented case of prolonged retrograde amnesia following propofol administration in a pediatric patient. Possible mechanisms and clinical management strategies related to this unique event are discussed.
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Paediatric anaesthesia · Apr 2007
Randomized Controlled Trial Comparative StudyProSeal as an alternative to endotracheal intubation in pediatric laparoscopy.
The increasing use of laparoscopic surgery in children mandates a leak-free airway device during carboperitoneum for which tracheal tubes (TT) have been traditionally used. The pediatric ProSeal is a recent introduction to the laryngeal mask airway (LMA) family. The ProSeal LMA (PLMA) has been successfully used in adult laparoscopic procedures. We hypothesized that the ProSeal can be equally effective in achieving adequate oropharyngeal seal and pulmonary ventilation during elective laparoscopic procedures in children. ⋯ The pediatric PLMA and TT have comparable ventilatory efficacy for elective short laparoscopic procedures.