Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2005
Randomized Controlled Trial Clinical TrialThe addition of clonidine 2 microg.kg-1 does not enhance the postoperative analgesia of a caudal block using 0.125% bupivacaine and epinephrine 1:200,000 in children: a prospective, double-blind, randomized study.
In this prospective, randomized, double-blind study, we compared the efficacy of 0.125% bupivacaine and epinephrine 1:200,000 with and without clonidine 2 microg.kg-1 for 'single shot' pediatric caudal analgesia. ⋯ We found that the addition of clonidine 2 microg.kg-1 to 0.125% bupivacaine with fresh epinephrine 1:200,000 for caudal analgesia did not significantly delay the time to first rescue analgesic or decrease the overall need for rescue analgesics in children 2-8 years undergoing surgical procedures below the umbilicus.
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Paediatric anaesthesia · Jun 2005
Randomized Controlled Trial Clinical TrialIntraoperative low-dose S-ketamine has no preventive effects on postoperative pain and morphine consumption after major urological surgery in children.
Clinical studies suggest low-dose ketamine may have preemptive effects on postoperative pain in adults. The objective of this study was to determine whether intraoperative low-dose S-ketamine reduces postoperative pain and morphine consumption in children undergoing major urological surgery. ⋯ Intraoperative low-dose S-ketamine had no effect on morphine consumption during the first 72 h after surgery. The differences in pain intensity and time to first PCA use probably reflect additional sedation and antinociceptive effects of S-ketamine rather than a true 'prevention' of pain.
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Paediatric anaesthesia · Jun 2005
Randomized Controlled Trial Comparative Study Clinical TrialSevoflurane (12% and 8%) inhalational induction in children.
Sevoflurane induction of anesthesia is frequently used in children. Rapidly performed inhalational induction may reduce excitation during early anesthesia. Increasing the total anesthetic MAC delivered to patients can be achieved by increasing volatile concentration or adding nitrous oxide. The latter reduces inspired oxygen concentration delivered, which may not be desirable. Even 8% sevoflurane induction is associated with excitation. A system capable of delivering 12% sevoflurane using two tandem vaporizers has been developed. ⋯ Twelve percent sevoflurane offers a smoother anesthesia induction than 8% in children of this age with no additional consequences for the cardiovascular system.
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Paediatric anaesthesia · Jun 2005
Comparative StudyA noninvasive estimation of mixed venous oxygen saturation using near-infrared spectroscopy by cerebral oximetry in pediatric cardiac surgery patients.
Near-infrared spectroscopy (NIRS) is a noninvasive optical monitor of regional cerebral oxygen saturation (rSO2). The aim of this study was to validate the use of NIRS by cerebral oximetry in estimating invasively measured mixed venous oxygen saturation (SvO2) in pediatric postoperative cardiac surgery patients. ⋯ Regional cerebral oximetry via NIRS correlates with SvO2 obtained via invasive monitoring. However, the wide limits of agreement suggest that it may not be possible to predict absolute values of SvO2 for any given patient based solely on the noninvasive measurement of rSO2. Near-infrared spectroscopy, using the INVOS 5100 cerebral oximeter, could potentially be used to indicate trends in SVO2, but more studies needs to be performed under varying clinical conditions.
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Paediatric anaesthesia · Jun 2005
Cerebral oxygenation monitoring using near infrared spectroscopy during controlled hypotension.
Controlled hypotension (CH) is used to limit intraoperative blood loss and decrease the need for homologous transfusions. Despite the efficacy of the technique, hypotension has the potential to affect cerebral perfusion and oxygen delivery. There are no data providing a direct measurement of cerebral oxygenation during this technique. ⋯ Our preliminary data with a measurement of cerebral oxygenation demonstrates the safety of CH within the accepted mean blood pressure recommendations of 55-65 mmHg.