Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2006
Case ReportsExtravasation of propofol is associated with tissue necrosis in small children.
Propofol is widely used for induction of anesthesia and many reports document extravasation and even intra-arterial injections without clinical sequelae. We report a case of tissue necrosis after subcutaneous injection of propofol in a 31-day-old infant.
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Paediatric anaesthesia · Aug 2006
Perioperative cardiac arrest and its mortality in children. A 9-year survey in a Brazilian tertiary teaching hospital.
The incidence of perioperative cardiac arrest and mortality in children is higher than in adults. This survey evaluated the incidence, causes, and outcome of perioperative cardiac arrests in a pediatric surgical population in a tertiary teaching hospital between 1996 and 2004. ⋯ Perioperative cardiac arrests were relatively higher in neonates and infants than in older children with severe underlying disease and during emergency surgery. The fact that all anesthesia attributable cardiac arrests were related to airway management and medication administration is important in prevention strategies.
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Paediatric anaesthesia · Jul 2006
Near infrared spectroscopy monitoring during pediatric aortic coarctation repair.
Near infrared spectroscopy (NIRS) measures regional tissue oxygenation continuously and noninvasively and may allow assessment of changes in regional perfusion in real time. ⋯ Monitoring rSO2-S provides real-time trend information of regional oxygenation below the aortic cross-clamp. The decline in rSO2-S during aortic cross-clamp was rapid and large in most neonates and young infants <1 year which suggests impairment of regional perfusion presumably because of a lack of adequate collateral circulation to the monitored regional tissue. In contrast, the rSO2-S changed only to a minor degree in most infants and children >1 year, possibly because they had time to develop a more adequate collateral circulation around incomplete aortic obstruction.
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Paediatric anaesthesia · Jul 2006
Review Case ReportsAnesthesia and Prader-Willi syndrome: preliminary experience with regional anesthesia.
The constellation of neonatal hypotonia, developmental delay, hypogonadism and obesity caused by hyperphagia was first reported in 1956 and subsequently termed Prader-Willi syndrome (PWS). Genetic analysis has demonstrated abnormalities of chromosome 15. ⋯ A lumbar plexus catheter was used to provide postoperative analgesia in one patient while regional anesthesia (fasica iliaca block, spinal anesthesia, and lateral vertical infraclavicular block) was used to provide primary intraoperative anesthesia in three other patients while avoiding the need for general anesthesia. Previous reports of the anesthesia care of patients with PWS are reviewed and the potential perioperative implications of the sequelae of PWS are discussed.