Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2005
Can continuous low current electrical stimulation distinguish insulated needle position in the epidural and intrathecal spaces in pediatric patients?
Muscle twitches elicited with electrical stimulation (6-17 mA) during epidural insertion indicate correct epidural needle placement while muscle twitches at a lower current (<1 mA) may indicate intrathecal needle placement. This study examined whether applying continuous electrical stimulation at 6 mA could indicate needle entry into the epidural space without inadvertently penetrating the intrathecal space. ⋯ Monitoring with an insulated needle with electrical stimulation at 6 mA may prevent unintentional placement of epidural needles into the intrathecal space.
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Paediatric anaesthesia · Nov 2005
Case ReportsEarly complication of pediatric central venous cannulation.
We describe a case of hemothorax following central venous catheter (CVC) insertion in an infant. Presumably injury occurred as a result of perforation with the dilator. Strategies to reduce the risk of complications and possible factors influencing the unsatisfactory delay in diagnosis, including the role of 'Fixation Error', are discussed.
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Paediatric anaesthesia · Nov 2005
Caudal injectate can be reliably imaged using portable ultrasound--a preliminary study.
Correct caudal cannula placement is essential for block success and the avoidance of complications. The aim of this study was to assess the use of a saline injection test bolus with ultrasound (US) imaging to identify correct cannula placement for caudal anesthesia. ⋯ These preliminary results suggest saline test bolus under US imaging is a reliable indicator of correct cannula position for caudal block. We found it safe, quick to perform, and provided additional useful information.
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Paediatric anaesthesia · Nov 2005
Case ReportsNeonatal pneumothorax--an unexpected perioperative complication.
We report our experience of three cases of intraoperative pneumothorax in neonatal surgical patients. Following a review of the literature, we discuss possible causes for each case and methods of treatment. We emphasize the need for inclusion of pneumothorax as a cause for cardiorespiratory instability even when no predisposition is identifiable and highlight the need for prompt treatment to prevent serious morbidity and mortality.
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Paediatric anaesthesia · Nov 2005
Clinical TrialPreliminary experience with oral dexmedetomidine for procedural and anesthetic premedication.
Oral premedication is often required in children to provide anxiolysis and lessen the psychological impact of hospitalization and/or procedures. We present our experience with dexmedetomidine as an oral premedicant prior to procedural sedation or anesthetic induction. ⋯ These preliminary data suggest that dexmedetomidine may be an effective oral premedicant prior to anesthesia induction or procedural sedation. We found that it was effective even in patients with neurobehavioral disorders in whom previous attempts at sedation had failed.