Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2003
Randomized Controlled Trial Clinical TrialAssessing behaviour in children emerging from anaesthesia: can we apply psychiatric diagnostic techniques?
No standardized instrument exists for the systematic analysis of emergence behaviour in children after anaesthesia. Our purpose was to evaluate children's behaviour prior to anaesthetic induction and immediately upon emergence to develop an assessment tool using psychiatric terminology and techniques. ⋯ This exploratory study suggests that postanaesthetic behaviour abnormalities with characteristics of distress or delirium can be categorized using known DSM-IV terminology; in our cohort this behaviour was dependent on age and anaesthetic technique.
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Paediatric anaesthesia · Sep 2003
Case ReportsAnaesthetic implications of the child with Robinow syndrome.
Robinow syndrome, originally described in 1969, consists of mesomelic brachymelia, short stature, genital hypoplasia and characteristic facies. Associated organ system involvement may include developmental delay, congenital heart disease, obstructive disorders of the urinary tract and renal cysts. ⋯ The authors present an 8-year-old boy, previously diagnosed with Robinow syndrome, who was admitted for an emergency surgical procedure. The perioperative implications of this disorder are reviewed.
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Paediatric anaesthesia · Sep 2003
Case ReportsLingual oedema associated with the prolonged use of an inappropriately large laryngeal mask airway (LMATM) in an infant.
A case report is presented of a 12-month-old infant who developed lingual oedema after the prolonged use of an inappropriately large laryngeal mask airway (LMATM). A size 2(1/2) LMA was used in a 10.6 kg infant during a 5 h operative procedure. Postoperatively, the patient developed significant tongue oedema, which gradually resolved with time and dexamethasone treatment. This rare complication demonstrates the potential danger of using an overly large LMA in an infant, especially for a significant period of time.
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Paediatric anaesthesia · Sep 2003
Case ReportsAnaesthesia for a child with Walker-Warburg syndrome.
Walker-Warburg syndrome (WWS) is a rare lethal autosomal recessive disorder manifested by characteristic central nervous system and eye malformations. We have not come across reports of general anaesthesia in a child with WWS in the English literature. ⋯ The child also had bilateral cleft lip, cleft palate, urogenital malformation and hydronephrosis. Despite many potential anaesthesia concerns, anaesthesia was uneventful in this child.
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Paediatric anaesthesia · Sep 2003
Efficacy and safety of continuous intravenous infusion of remifentanil in preterm infants undergoing laser therapy in retinopathy of prematurity: clinical experience.
Preterm infants often require surgery. As experimental evidence suggests that premature infants may experience pain and this could even result in fatal complications, the anaesthesiologist must face problems related to lowbirth weight, high risk of hypothermia, concomitant pulmonary disease and metabolic and receptor immaturity. Recently remifentanil has been considered an optimal analgesic drug in a preterm infant undergoing mechanical ventilation and frequent surgical manoeuvres, but no clinical studies have been reported in the literature. The aim of our study was to evaluate the efficacy of a continuous intravenous infusion of remifentanil in premature infants undergoing laser therapy for retinopathy of prematurity (ROP). ⋯ A continuous infusion of remifentanil allowed optimal control of surgical stress and a return to preoperative status and ventilatory settings without side-effects.