Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2006
Randomized Controlled Trial Comparative StudyPerception of pain following rectal administration of morphine in children: a comparison of a gel and a solution.
Rectal administration of morphine is one possible route of delivery in children. The aim of this study was to determine the pain experience during rectal administration of two different morphine preparations. ⋯ The results indicate that most of the children tolerated rectal administration of morphine well in terms of pain experience, in both gel and solution form. The morphine gel, intended for rectal use appears to be the preparation of choice in children aged 1-6 years.
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Paediatric anaesthesia · Feb 2006
Case ReportsThoracic epidural catheter in the management of a child with an anterior mediastinal mass: a case report and literature review.
We describe a case of an anterior mediastinal mass compressing the right main bronchus that required a biopsy through a thoracotomy incision. The anesthetic management of these patients is associated with several risks and challenges, including potential airway compression and cardiovascular collapse. Inhalation induction and maintenance of spontaneous respiration is recommended to preserve normal transpulmonary pressure gradient and improve flow through conducting airways. ⋯ The absolute risk of nerve injury and epidural hematoma for this procedure is unknown and hard to define in this patient population. We reviewed multiple studies and case reports addressing its safety and reported side effects. Finally, we emphasize that a thoracic epidural anesthesia is a reasonable choice that can be applied carefully in special situations even for children under general anesthesia.
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Paediatric anaesthesia · Feb 2006
Randomized Controlled Trial Comparative StudyComparison of caudal ketamine with lidocaine or tramadol administration for postoperative analgesia of hypospadias surgery in children.
This study was designed to investigate whether the addition of tramadol or lidocaine to ketamine would enhance the quality of intra- and postoperative analgesia for hypospadias surgery in children. ⋯ Caudal ketamine (0.25 mg.kg(-1)), plus lidocaine (2% 2 mg.kg(-1)) significantly reduced sevoflurane concentration compared with ketamine (0.25 mg.kg(-1)) + tramadol (1 mg.kg(-1)). We suggested that both ketamine + lidocaine and ketamine + tramadol provided very effective and long duration of analgesia, similarly. However, analgesia quality is superior in the ketamine-lidocaine group postoperatively.
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Paediatric anaesthesia · Feb 2006
Case ReportsThe postoperative cardiovascular arrest of a 5-year-old male: an initial presentation of Duchenne's muscular dystrophy.
Anesthesia may be administered to patients with Duchenne's muscular dystrophy, but cases are reported in which apparently healthy children suffer hyperkalemic cardiac arrest. We present the case of a 5-year-old boy whose muscular dystrophy was discovered following a fatal, perioperative cardiac arrest in the postanesthesia care unit.
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Paediatric anaesthesia · Feb 2006
Randomized Controlled Trial Comparative StudyComparison of cuffed, uncuffed tracheal tubes and laryngeal mask airways in low flow pressure controlled ventilation in children.
The use of low flow circle systems necessitates a 'leak free' breathing system which is commonly achieved by using a cuffed tracheal tube (TT). We hypothesized that low flow circle system anesthesia can equally effectively be achieved by using the LMA in pediatric anesthesia. ⋯ We conclude that pressure controlled ventilation using an LMA is an alternative to a cuffed TT during low flow circle system anesthesia in children. Low FGF is unlikely to be achieved consistently using an uncuffed TT because of a substantial leak.