Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2004
Clinical TrialElectroencephalograph variables, drug concentrations and sedation scores in children emerging from propofol infusion anaesthesia.
Inadequate sedation or oversedation are common problems in Paediatric Intensive Care because of wide variations in drug response and the lack of objective tests for sedative depth. We undertook a pilot study to try to identify correlates of propofol drug concentration, electroencephalographic (EEG) variables and observed behaviour during a stepwise reduction in propofol infusion after paediatric cardiac surgery. ⋯ In this group of patients receiving opioid analgesia and relatively high doses of propofol, sedation scores were unhelpful in predicting arousal. The SR correlated with propofol blood concentrations and clinical arousal and may have potential as a predictive tool for arousal in children.
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Paediatric anaesthesia · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialThe clinical effect of mixing different proportions of rocuronium and mivacurium.
A synergistic effect has been described when rocuronium (Roc) and mivacurium (Miv) are combined in equal (i.e. 1:1) ED95 proportions at various total doses. We have investigated the effect of Roc or Miv alone and four different ratios (1:4, 2:3, 3:2 and 4:1) of Roc and Miv mixed to a total dose of 1.33 x ED95. The primary outcome is the ratio producing the maximum enhancement of duration of clinical effect. ⋯ Combinations of Roc and Miv show a synergistic effect, which appears maximal as the mixture approaches a 1:1 ratio of their ED95s. This combination acted as if a larger effective dose of a single (new) drug had been given, but did not offer the advantage of both rapid onset and short duration of effect.
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Paediatric anaesthesia · Feb 2004
Comparative Study Clinical TrialTranscutaneous carbon dioxide monitoring during diabetic ketoacidosis in children and adolescents.
Our aim was to evaluate the utility of transcutaneous CO2 (TC-CO2) monitoring in following the response to therapy in children and adolescents in diabetic ketoacidosis (DKA) requiring ICU admission. ⋯ TC-CO2 correlates with serum HCO3- and can be used to follow therapy in children and adolescents in DKA.
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Paediatric anaesthesia · Feb 2004
ReviewConjoined twins--the anaesthetic management of 15 sets from 1991-2002.
The Red Cross War Memorial Children's Hospital, Cape Town, South Africa is the only dedicated children's hospital in sub-Saharan Africa and, as such, is the referral hospital for complex procedures from this region. Fifteen sets of conjoined twins have presented for separation from 1991 to 2002, and a total of 34 sets since 1964. Anaesthesia for procedures on conjoined twins is a demanding, exacting and meticulous exercise, whether prior to or during separation. ⋯ Planning for the postseparation period and the reconstruction and rehabilitation of the babies is essential from the time of their initial admission. Meticulous attention to detail, monitoring and vigilance are mandatory. Successful management of conjoined twins relies on close communication and cooperation of all members of the multidisciplinary team.