Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2005
Case ReportsRemifentanil for sedation and analgesia in a preterm neonate with respiratory distress syndrome.
We present the efficacy and safety of the use of remifentanil for intubation, sedation and analgesia in a preterm infant during mechanical ventilation for respiratory distress syndrome. A 34-week-old baby, born by cesarean delivery that developed respiratory distress, required intubation and ventilatory support. For intubation, the baby was given midazolam (0.2 mg.kg(-1)) and remifentanil (1 microg.kg(-1)). ⋯ The remifentanil infusion was then discontinued and 30 min later the baby was awake and extubated with success. There were no side effects after intubation or during the continuous infusion. The profile of remifentanil allowing a rapid recovery, the absence of side effects and a good level of sedation and analgesia support the choice of this opioid for sedation in the NICU.
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Paediatric anaesthesia · Nov 2005
Case ReportsSubmental intubation for cancrum oris: a case report.
Cancrum oris (Noma) is a devastating gangrenous disease that leads to severe tissue destruction in the face. We describe the anesthetic management of a 12-year-old girl with cancrum oris sequelae in a Rural Secondary level Hospital in Central India (Padhar Hospital). She presented with a large defect in her upper lip on the left side that extended into the columella and the floor of the left nostril. ⋯ She made a satisfactory recovery and the submental scar healed without complication or scarring. We describe briefly the features of cancrum oris and review the technique of submental intubation (described in adults with midfacial trauma). The use of submental intubation in children and for cancrum oris sequelae has not been previously reported.
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Paediatric anaesthesia · Nov 2005
Cardiac tamponade associated with a peripheral vein central venous catheter.
We present a case of cardiac tamponade associated with placement of a central venous catheter (CVC) via a peripheral vein in a 14-year-old girl with idiopathic scoliosis undergoing corrective surgery. A number of complications have been described in association with CVC misplacement. Sporadic cases of cardiac tamponade from this have been reported, but the actual incidence is unknown. ⋯ The main diagnostic test for this condition is echocardiography and the only effective treatment is drainage of the pericardial effusion. Echocardiography should be performed before pericardiocentesis except in life-threatening situations or high clinical suspicion. Although they are rare, it is important to be aware of the potential for CVC complications.
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Paediatric anaesthesia · Nov 2005
Continuous sciatic block for leg and foot surgery in 160 children.
The aim of this study was to assess the safety and efficacy of continuous sciatic block for lower limb surgery in children. ⋯ Sciatic block with a single shot 3-in-1 block for tourniquet pain and light general anesthesia provides good intraoperative conditions for leg and foot surgery and adequate postoperative pain relief. Additional sedation to minimize the discomfort of a cast may be a consideration in the first 24 h.
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Paediatric anaesthesia · Oct 2005
Randomized Controlled Trial Comparative StudyA comparison of three methods for estimating appropriate tracheal tube depth in children.
Estimating appropriate tracheal tube (TT) depth following tracheal intubation in infants and children presents a challenge to anesthesia practitioners. We evaluated three methods commonly used by anesthesiologists to determine which one most reliably results in appropriate positioning. ⋯ Deliberate mainstem intubation most reliably results in appropriate TT depth in infants and children.