Paediatric anaesthesia
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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
Case ReportsAcute pancreatitis induced by short-term propofol administration.
The incidence of a drug-induced pancreatitis is rare and so far more than 85 different drugs have been reported to have induced pancreatitis. Some case reports consider a relationship between propofol and acute pancreatitis. However, in these cases a number of different drugs were coadministered, thus preventing a clear causal link being established. ⋯ She developed pancreatitis within hours after exposure to propofol. Other possible triggers, e.g. gallstones or infection were ruled out. Physicians should consider pancreatitis as a potentially life-threatening adverse event associated with propofol sedation, which is nowadays extensively used.
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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
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.