Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2005
Case ReportsAnesthetic management of a patient with MERRF syndrome.
There are several specific considerations regarding anesthesia in patients with mitochondrial disease. We describe the successful administration of a combined general and epidural anesthesia with sevoflurane maintenance in a patient with myoclonic epilepsy with ragged red fibers (MERRF syndrome) scheduled for surgical treatment of bilateral clubfoot.
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Paediatric anaesthesia · Jan 2005
Case ReportsUse of intravenous midazolam and clonidine in cyclical vomiting syndrome: a case report.
We report a case of a teenage boy with cyclical vomiting syndrome (CVS) who was referred to the anesthesia-run postoperative pain service for symptom management. His symptoms were uncontrolled by oral pizotifen prophylaxis and acute therapy with intravenous (IV) hydration and ondansetron. A continuous low dose IV midazolam infusion was added to his treatment regimen (as is instituted for recalcitrant postoperative nausea and vomiting) with benefit, but not total symptom resolution. ⋯ Many agents have been used in CVS therapy but no trials have been done. Neither midazolam nor clonidine has been reported previously as used in the treatment of CVS. The apparent success of this combination raises possibilities both for future trials and research into the pathogenesis of CVS.
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We report a potentially life-threatening tracheal lesion that caused postextubation stridor in a child following dental surgery. The child developed a cough, dysphonia, stridor, and respiratory distress hours after his operation. Standard therapy for postextubation stridor was ineffective. ⋯ This revealed a fibrinous membrane that was attached to the anterior trachea and required mechanical ablation. The child made an uneventful recovery. This lesion has not been reported in children before and we believe that it is important in the differential diagnosis of postextubation stridor as it requires specific therapy.
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Paediatric anaesthesia · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialWhich may be effective to reduce blood loss after cardiac operations in cyanotic children: tranexamic acid, aprotinin or a combination?
Children with cyanotic heart disease undergoing cardiac surgery in which cardiopulmonary bypass is used are at increased risk of postoperative bleeding. In this study, the authors investigated the possibility of reducing postoperative blood loss by using aprotinin and tranexamic acid alone or a combination of these two agents. ⋯ Our results suggested that both agents were effective to reduce postoperative blood loss and transfusion requirements in patients with cyanotic congenital heart disease. However, the combination of aprotinin and tranexamic acid did not seem more effective than either of the two drugs alone.