Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2004
Clinical Trial Controlled Clinical TrialLevobupivacaine spinal anesthesia in neonates: a dose range finding study.
Our aim was to determine the clinical efficacy of levobupivacaine for awake spinal anesthesia in ex-premature infants having lower abdominal surgery. The secondary aim was to determine the minimum local analgesic dose (MLAD) defined as the median effective local anesthetic dose for spinal anesthesia in neonates. ⋯ Levobupivacaine is an effective agent for spinal anesthesia in neonates at a recommended dose of 1 mg x kg(-1). It appears to be of equivalent potency to racemic bupivacaine for motor blockade in ex-premature infants requiring lower abdominal surgery.
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Paediatric anaesthesia · Oct 2004
Comment Randomized Controlled Trial Clinical TrialEarly intravenous cannulation in children during sevoflurane induction.
It has been shown that early placement of an intravenous line in children anesthetized with halothane is equally safe compared with later placement. Whether this is true of sevoflurane is not known. ⋯ Following an inhalation induction with sevoflurane in children, movement with intravenous placement was greater, and the incidence of laryngospasm was higher, when the intravenous access was attempted 30 s rather than 120 s following loss of lid reflex. We recommend waiting two min following the loss of lid reflex before attempting intravenous placement in children receiving an inhalation induction with sevoflurane.
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Paediatric anaesthesia · Oct 2004
Randomized Controlled Trial Clinical TrialThe effect of remifentanil on cerebral blood flow velocity in children anesthetized with propofol.
Cerebrovascular stability and rapid anesthetic emergence are desirable features of a neuroanesthetic regimen. In this randomized crossover study the effect of a low-dose remifentanil infusion on cerebral blood flow velocity (CBFV) in children anesthetized with propofol was evaluated. ⋯ The addition of remifentanil to propofol anesthesia in children causes a reduction in MAP and HR without affecting CBFV. This may imply that cerebral blood pressure autoregulation is preserved in children under propofol and remifentanil anesthesia.
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Paediatric anaesthesia · Oct 2004
Droperidol for perioperative sedation causes a transient prolongation of the QTc time in children under volatile anesthesia.
Droperidol is useful for postoperative sedation in infants and children after cardiac surgery because it provides sedation and akinesia with minimal respiratory depression. However, droperidol has been associated with QT prolongation and ventricular arrhythmias. We investigated, if neuroleptanalgesic doses of droperidol led to QT prolongation and cardiac arrhythmias in children undergoing cardiac surgery. ⋯ The statistically significant prolongation of QTc time after a sedative dose of droperidol is of concern because it may increase the risk for malignant cardiac arrhythmias. A large, prospective study is necessary to identify the true risk for arrhythmias after droperidol in this patient population, but our study suggests that any arrhythmogenic risk, if present, will be very transient, since the increase in QTc time was limited to a period of less than 30 min after the bolus.