Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2007
Randomized Controlled Trial Comparative StudyHemodynamic differences between propofol-remifentanil and sevoflurane anesthesia for repair of cleft lip and palate in infants.
Propofol-remifentanil anesthesia is widely used in adults but few studies are available in infants. We aimed at comparing the hemodynamic effects of propofol-remifentanil vs sevoflurane-fentanyl anesthesia. In addition, we sought to investigate recovery and whether remifentanil induced acute opioid tolerance. ⋯ A high-dose remifentanil-propofol infusion was associated with a higher blood pressure and lower heart rate than sevoflurane-fentanyl anesthesia in infants. Postoperative morphine consumption, recovery time and quality were similar.
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Paediatric anaesthesia · Jan 2007
Randomized Controlled TrialIsoflurane is associated with a similar incidence of emergence agitation/delirium as sevoflurane in young children--a randomized controlled study.
Children may be agitated or even delirious especially when recovering from general anesthesia using volatile anesthetics. Many trials have focused on the newer agents sevoflurane and desflurane but for the widely used isoflurane little is known about its potential to generate agitation. We investigated the emergence characteristics of small children after sevoflurane or isoflurane with caudal anesthesia for postoperative pain control. ⋯ In our randomized controlled study, we found no difference in the incidence of EA or ED between sevoflurane and isoflurane. Therefore, the decision to use one or the other should not be based upon the incidence of EA or ED.
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Paediatric anaesthesia · Jan 2007
Comparative StudyNeonatal resuscitation courses for pediatric residents: comparison between Khartoum (Sudan) and Padova (Italy).
The efficacy of a Neonatal Resuscitation Program (NRP) has been previously evaluated in developed countries, but there is a lack of information regarding the impact of this teaching program in developing countries. Our aim was to compare the knowledge gained by University of Khartoum (Sudan) and University of Padova (Italy) pediatric residents following participation in the NRP course. ⋯ The trend of the knowledge attainment of both Sudanese and Italian pediatric residents was similar after NRP course participation. An NRP is effective in teaching neonatal resuscitation in developing countries.
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Paediatric anaesthesia · Jan 2007
Continuous SvO2 measurement in infants undergoing congenital heart surgery--first clinical experiences with a new fiberoptic probe.
SvO2-guided therapy, using fiberoptic oximetric catheters can help to improve the outcome after complex congenital heart surgery especially in infants undergoing the Stage 1-Norwood-Procedure. So far, fiberoptic catheters have to be placed transthoracically by the surgeon into the vena cava or the pulmonary artery putting the infant at an additional risk of bleeding at the time of catheter removal. ⋯ We believe that compared with transthoracically inserted oximetric catheter, the presented percutaneous technique avoids additional risks at the time of catheter removal (i.e. bleeding) and has become part of our standard management.