Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2005
Randomized Controlled TrialThe evaluation of propofol dosage for anesthesia induction in children with cerebral palsy with bispectral index (BIS) monitoring.
We designed a randomized prospective study to investigate whether developmentally delayed children with cerebral palsy (CP) need a lower dosage of propofol for induction than normal children using bispectral index (BIS) monitoring criteria. ⋯ Our data suggest that noncommunicative/nonverbal children with CP require less propofol to obtain the same BIS values (i.e. 35-45) than do otherwise healthy children.
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Paediatric anaesthesia · Dec 2005
Randomized Controlled TrialThe efficacy of a subhypnotic dose of propofol in preventing laryngospasm following tonsillectomy and adenoidectomy in children.
Laryngospasm is a well-known problem typically occurring immediately following tracheal extubation. Propofol is known to inhibit airway reflexes. In this study, we sought to assess whether the empiric use of a subhypnotic dose of propofol prior to emergence will decrease the occurrence of laryngospasm following extubation in children. ⋯ During emergence from inhalational anesthesia, propofol in a subhypnotic dose (0.5 mg.kg(-1)) decreases the likelihood of laryngospasm upon tracheal extubation in children undergoing tonsillectomy with or without adenoidectomy.
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Paediatric anaesthesia · Dec 2005
Randomized Controlled TrialDoes dexmedetomidine prevent emergence delirium in children after sevoflurane-based general anesthesia?
Emergence agitation or delirium (ED) is a frequent phenomenon in children recovering from general anesthesia (GA). Dexmedetomidine, an alpha2 receptor agonist, has analgesic and sedative properties that might be helpful in the management of ED. We studied the effects of a continuous perioperative infusion of 0.2 microg.kg(-1).h(-1) dexmedetomidine on the incidence of ED in 50 children aged 1-10 years scheduled for sevoflurane-based GA. ⋯ The perioperative infusion of 0.2 microg.kg(-1).h(-1) dexmedetomidine decreases the incidence and frequency of ED in children after sevoflurane-based GA without prolonging the time to extubate or discharge.
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Paediatric anaesthesia · Dec 2005
Comparative Study Clinical TrialClonidine added to bupivacaine in neonatal spinal anesthesia: a prospective comparison in 124 preterm and term infants.
Spinal anesthesia (SA) remains the 'gold standard' in neonatal anesthesia for inguinal herniorrhaphy but its short duration impedes its usefulness. We previously demonstrated that clonidine prolongs neonatal SA without immediate side effects. ⋯ The clinical significance of short apneas, recovering spontaneously without desaturation, remains debatable. It is concluded that addition of clonidine to neonatal SA results in acceptable side effects. Side effects must be compared with the potential advantages before future recommendations.
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Paediatric anaesthesia · Dec 2005
Case ReportsSevere hepatotoxicity after sevoflurane anesthesia in a child with mild renal dysfunction.
Sevoflurane, an anesthetic agent with methyl isopropyl fluorinated ether structure, has a very low potential for hepatotoxicity. Nevertheless, a few cases of hepatotoxicity have been reported since its introduction into clinical practice. The underlying pathophysiology may be multifactorial and sometimes nonspecific. We report a case of severe hepatotoxicity after anesthesia with sevoflurane in a child with preexisting mild renal dysfunction.