Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2004
Randomized Controlled Trial Comparative Study Clinical TrialIntraoperative ketorolac is an effective substitute for fentanyl in children undergoing outpatient adenotonsillectomy.
In this prospective randomized double-blind study, we compared the incidence of emesis and 48-h recovery profiles after a single dose of ketorolac vs fentanyl in dexamethasone-pretreated children undergoing ambulatory adenoidectomy and laser-assisted tonsillectomy (ADLAT). We evaluated the hypothesis that avoiding the use of opioids and replacing them with an equianalgesic dose of ketorolac, a nonsteroidal anti-inflammatory drug, would reduce the incidence of postoperative nausea and vomiting (PONV). ⋯ Ketorolac showed no advantage over fentanyl in reducing the incidence of PONV in children undergoing ADLAT.
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Paediatric anaesthesia · Apr 2004
Randomized Controlled Trial Clinical TrialNeuromuscular recovery following rocuronium bromide single dose in infants.
Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life. ⋯ Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg.kg(-1) resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg.kg(-1) resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants.
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Paediatric anaesthesia · Apr 2004
Randomized Controlled Trial Clinical TrialThe cardiac analgesic assessment scale (CAAS): a pain assessment tool for intubated and ventilated children after cardiac surgery.
This study evaluated the reliability and validity of the Cardiac Analgesic Assessment Scale (CAAS) as a postoperative pain instrument for children after cardiac surgery. ⋯ This study provides evidence that postoperative pain in sedated and intubated children after cardiac surgery can be assessed reliably using a formal pain tool.
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Paediatric anaesthesia · Apr 2004
Review Case ReportsManaging sedation withdrawal in children who undergo prolonged PICU admission after discharge to the ward.
Children who undergo a prolonged stay within the intensive care unit require adequate sedation and analgesia. During the recovery phase there will need to be a period of sedation withdrawal to prevent occurrence of an abstinence syndrome. We present a strategy developed within our hospital for managing this process which uses the resource of the Pain Service, along with guidelines to help prevent the development of withdrawal, and a plan for managing any signs of abstinence which occur.