Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2003
Case ReportsAnaesthesia for an adolescent with mitochondrial encephalomyopathy-lactic acidosis-stroke-like episodes syndrome.
Anaesthesia for patients with mitochondrial disorders occurs with regularity, either for a diagnostic or therapeutic procedure associated with the syndrome or for unassociated surgery. We report the case of a 17-year-old boy with mitochondrial encephalomyopathy-lactic acidosis-stroke-like episodes (MELAS) syndrome who underwent a laparotomy for fundoplication. The potential hazards of anaesthesia for this patient, and the steps taken to avoid them, are discussed.
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Paediatric anaesthesia · Jun 2003
Case ReportsDifferential lung ventilation in an infant using LMA and a long tracheal tube.
This is a case report of differential lung ventilation in an infant using a conventional laryngeal mask airway (LMATM) and a commercially available longer paediatric tracheal tube. This 2-month-old infant had her left-sided congenital diaphragmatic hernia repaired on the sixth day of her life, and had been mechanically ventilated. ⋯ To avoid hyperinflating the right middle lobe, and to expand the right lower lobe without providing a high airway pressure on the left lung, the dependent lung (i.e. left lung) was ventilated with an LMA, and the right lower lobe was expanded with a long tracheal tube inserted through the LMA via the swivel connector. This combination of a conventional LMA and a commercially available longer paediatric tracheal tube could be another way of providing differential ventilation in infants.
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Paediatric anaesthesia · Jun 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison of 0.2% ropivacaine and 0.25% bupivacaine for axillary brachial plexus blocks in paediatric hand surgery.
The purpose of this study was to compare the use of ropivacaine 0.2% with bupivacaine 0.25% for axillary brachial plexus block in children undergoing hand surgery. ⋯ Ropivacaine 0.2% is as effective as bupivacaine 0.25% for axillary brachial plexus blocks in children undergoing hand surgery.
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Paediatric anaesthesia · Jun 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison between instillation of bupivacaine versus caudal analgesia for postoperative analgesia following inguinal herniotomy in children.
In this study we compare the postoperative pain relief for inguinal herniotomy in children provided by instillation of bupivacaine into the wound with that provided by a caudal block. ⋯ Instillation of bupivacaine into a wound provides postoperative pain relief following hernia repair, which is as effective as that provided by a postoperative caudal block.
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Paediatric anaesthesia · Jun 2003
Randomized Controlled Trial Clinical TrialDouble-blind randomized placebo-controlled trial of the effect of ketamine on postoperative morphine consumption in children following appendicectomy.
Ketamine has an opioid sparing effect following surgery in adults. This study investigated whether a similar effect is seen following appendicectomy in paediatric patients. ⋯ In this paediatric population intravenous ketamine did not have a morphine sparing effect. The increased incidence of side-effects, especially hallucinations, reported by patients given a ketamine infusion may limit the further use of postoperative ketamine in children.