Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2006
Performance of a novel pressure release valve for cuff pressure control in pediatric tracheal tubes.
Acute and chronic hyperinflation of tracheal tube cuffs represents a persistent risk factor for airway damage in children when cuffed tracheal tubes are used. In order to overcome this particular risk, a cuff pressure (CP) pop-off valve has been designed to avoid CP exceeding 20 cmH(2)O. ⋯ These preliminary results show that the CP pop-off valve limits the effect of rapid, potentially dangerous manual cuff inflation maneuvers and reliably prevents CP exceeding the predetermined level of 20 cmH(2)O when exposed to nitrous oxide.
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Arthrogryposis multiplex congenita (AMC) is a congenital symptom complex characterized by multiple joint contractures. AMC results from fetal akinesia due to extrinsic factors (oligohydramnios) or primary neurogenic or myopathic conditions of the fetus. ⋯ The perioperative care of patients with AMC should consider not only the physical manifestations of the disease process, but also the implications of the underlying neuromuscular disease. The most common perioperative issues included difficulties with airway management, problematic intravenous access, and intraoperative hyperthermia.
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Paediatric anaesthesia · Dec 2005
Case ReportsResistance to cisatracurium in a patient with MELAS syndrome.
There are conflicting reports on the response of mitochondrial myopathy patients to the neuromuscular blocking drugs, showing either normal response or marked sensitivity. We present a patient with MELAS syndrome who underwent Nissen fundoplication and gastrojejunostomy. Marked resistance to the nondepolarizing muscle relaxant, cisatracurium was observed. The anesthesia management, as well as the various causes of resistance to cisatracurium in this patient are discussed.