Paediatric anaesthesia
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Paediatric anaesthesia · May 2003
Increased respiratory symptoms following surgery in children exposed to environmental tobacco smoke.
The aim of this study was to determine if children exposed to environmental tobacco smoke (ETS) via parental smoking (ETS+) developed more respiratory symptoms resulting in longer recovery times following surgical outpatient procedures compared with children of nonsmoking parents (ETS-). ⋯ In children undergoing general anaesthesia for inguinal hernia repair, ETS exposure was associated with an increased frequency of respiratory symptoms during emergence from anaesthesia and during postoperative recovery.
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The dorsal penile nerve block (DPNB) is a common form of regional anaesthesia for circumcisions in children. The safety of this block has been questioned following several case reports of potentially serious complications. ⋯ We feel that the DPNB is a safe technique for circumcisions in infants and children.
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Paediatric anaesthesia · May 2003
Case ReportsFlumazenil is innocuous in a paroxysmal supraventricular tachycardia and radiofrequency ablation: a paediatric case report and review of the literature.
The efficacy and safety of flumazenil in reversing midazolam-induced paradoxical reaction in a child suffering from paroxysmal supraventricular tachycardia (PSVT) and undergoing radiofrequency ablation procedure has not been described before. We report a boy who had suffered for years from poorly controlled PSVT because of noncompliance to medications and was being sedated by midazolam and morphine (4 mg each) and prepared for radiofrequency ablation when he began attempting to speak, writhing and flailing his arms, for which physical restraint was required. We also review the current knowledge on the subject. ⋯ After that procedure, he awoke calm and pain free with no recollection of the aggressive episode. He was kept for 24 h in an intermediate cardiac care unit and was then discharged home. This apparent first report on the efficacious use of flumazenil for the reversal of a paradoxical reaction to midazolam during an electrophysiological study suggests that it neither induces abnormal heart rate nor interferes with the electrophysiological study or the ablation procedure.
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Paediatric anaesthesia · May 2003
Case ReportsLife threatening subcutaneous emphysema following surgical repair of tracheocutaneous fistula.
A 9-year-old male child posted for closure of tracheocutaneous fistula developed extensive subcutaneous emphysema resulting in acute respiratory distress immediately after transfer to recovery room. The clinical management, precautions and other complications of closure of tracheocutaneous fistula are discussed.