Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2003
Randomized Controlled Trial Clinical TrialOral high-dose midazolam premedication for infants and children undergoing cardiovascular surgery.
The purpose of this study was to determine whether oral midazolam 1.5 mg x kg(-1) is a safe and effective alternative to standard-dose midazolam (0.5-1.0 mg x kg(-1)) premedication for infants and children with congenital heart disease. ⋯ Oral midazolam 1.5 mg x kg(-1) is excellent for preanaesthetic medication for infants and children undergoing cardiovascular surgery.
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Paediatric anaesthesia · Oct 2003
Case ReportsIntraoperative transoesophageal echocardiography in a low birth weight neonate with atrioventricular septal defect.
An 18-day-old male neonate (45 cm, 1.8 kg) with a history of cyanosis and congestive heart failure from an atrioventricular septal defect (AVSD) with a large left-to-right shunt was scheduled for surgical repair of the AVSD. After routine induction of anaesthesia with fentanyl and vecuronium, a 4.5-mm diameter transoesophageal echocardiography (TOE) probe was inserted into the oesophagus, and systematic echocardiographic evaluation was performed during surgery. After cardiopulmonary bypass was stopped, intraoperative TOE revealed mild residual mitral valve regurgitation. ⋯ The patient's cardiac output was low in the postoperative intensive care unit. TOE was performed the next day to detect the source of this problem, revealed severe regurgitation compared with that observed intraoperatively. TOE was useful for evaluation of the residual mitral valve regurgitation, and we reconfirmed the importance of continuous monitoring even in a low birthweight neonate undergoing repair of a complete AVSD.
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Paediatric anaesthesia · Oct 2003
Comment Letter Case ReportsPostintubation tracheal stenosis in an 11-year-old boy: a surgical and anaesthetic challenge.
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Paediatric anaesthesia · Oct 2003
Case ReportsSystemic embolism in an infant following haemangioma embolization: a two-step process.
A case is presented of therapeutic embolization of a hypervascular hamartoma of the liver, in a term baby. During the procedure signs of pulmonary embolism occurred and the baby subsequently died from myocardial ischaemia. Potential intrathoracic shunts of the newborn together with changes associated with the vascular tumour are thought to have allowed systemic embolization of the embolic material.
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Paediatric anaesthesia · Oct 2003
Case ReportsAnaesthetic management in children with metachromatic leukodystrophy.
We present a case of metachromatic leukodystrophy in a child who required surgery for gastro-oesophageal reflux. In spite of his demyelinating disease, we used a lumbar epidural technique with general anaesthesia; the epidural catheter allowed us to continue the analgesia postoperatively and to avoid opioids in this high risk patient.