Paediatric anaesthesia
-
Paediatric anaesthesia · Dec 2004
Comparative Study Clinical TrialS-ketamine and s-norketamine plasma concentrations after nasal and i.v. administration in anesthetized children.
It has been suggested that nasal administration of s-ketamine may be used to improve sedation or premedication in combination with nasal midazolam in pediatric patients. In this study we measured and compared plasma concentrations of s-ketamine and its main metabolite s-norketamine after nasal and i.v. administration in preschool children. ⋯ Nasal administration of s-ketamine 2 mg x kg(-1) results in a wide spread of plasma concentrations and absorption times. Rapid and high level drug absorption after nasal drug administration is possible. The use of a pulse oximeter and continuous observation after nasal administration of s-ketamine for pediatric premedication is recommended.
-
Paediatric anaesthesia · Dec 2004
Randomized Controlled Trial Comparative Study Clinical TrialA randomized, double-blind comparison study of EMLA and ELA-Max for topical anesthesia in children undergoing intravenous insertion.
Topical anesthetics may help reduce discomfort associated with procedures involving needle-puncture, such as intravenous (i.v.) insertions, in children. EMLA cream has become a common, noninvasive therapy for topical anesthesia in children. ELA-Max is a recently introduced topical anesthetic cream marketed as being as effective in producing topical anesthesia after a 30-min application as EMLA is after a 60-min application. The purpose of this research was to compare ELA-Max at 30 min with EMLA at 60 min for providing topical anesthesia for i.v. insertions in children. ⋯ Results from this study support the claim that a 30-min application of ELA-Max (with occlusion) is as effective as a 60-min application of EMLA (with occlusion) for producing topical anesthesia for i.v. insertion in children.
-
Paediatric anaesthesia · Dec 2004
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialOral clonidine does not change ventilatory response to carbon dioxide in sevoflurane-anesthetized children.
Clonidine is a useful premedicant for pediatric anesthesia. The drug has potential for ventilatory depression. The aim of the current study was to determine the effects of clonidine premedication on the ventilatory response to hypercapnia during sevoflurane anesthesia using the carbon dioxide (CO(2)) steady state method. ⋯ These data suggest that oral clonidine is a suitable premedication for sevoflurane anesthesia under spontaneous breathing conditions in children.
-
Paediatric anaesthesia · Dec 2004
Case ReportsAnesthetic management of the complications of previously undiagnosed ingested foreign body in a pediatric patient.
A case of a previously undiagnosed ingested foreign body, subsequent acquired tracheoesophageal fistula and airway obstruction in a pediatric patient is described. We suggest that the capability to provide cardiopulmonary bypass was a key factor in this patient's survival.
-
Paediatric anaesthesia · Dec 2004
Comparative Study Clinical TrialTissue oxygenation monitoring during major pediatric surgery using transcutaneous liver near infrared spectroscopy.
The aim of the study was to compare liver tissue oxygenation determined by near infrared spectroscopy (NIRS) with central venous oxygen saturation (SvO(2)) and intestinal perfusion as measured by gastric intramucosal pH (pHi) in pediatric surgical patients. ⋯ TOI(Liver) provided a better trend monitor of central venous oxygen saturation than gastric intramucosal pH. Because of its limited sensitivity and specificity to indicate deterioration of SvO(2), liver tissue oxygenation measured by transcutaneous NIRS does not provide additional practical information for clinical management.