Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2002
Randomized Controlled Trial Clinical TrialAnalgesia for paediatric tonsillectomy and adenoidectomy with intramuscular clonidine.
After undergoing tonsillectomy and adenoidectomy (T&A), children may experience significant pain. Clonidine, an alpha2 agonist, exhibits significant analgesic properties. The current investigation sought to determine whether intramuscular (I.M.) clonidine would decrease pain in paediatric patients undergoing T&A. ⋯ We do not recommend adding i.m. clonidine (2 microg x kg(-1)) to the analgesic regimen of children undergoing tonsillectomy and adenoidectomy.
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A case of unexpected difficult laryngoscopy in a patient with gross hydrocephalus and generalized hypertonus is described. The 30-month-old girl had no antecedent history of such difficulty, having had two recent uneventful anaesthetics. We suggest that the reason for our inability to open the patient's mouth was a result of contracture of the temporalis muscle. The patient was managed using a laryngeal mask airway with controlled ventilation.
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Paediatric anaesthesia · Sep 2002
Case ReportsApnoea in a former preterm infant after caudal bupivacaine with clonidine for inguinal herniorrhaphy.
Awake regional anaesthesia for inguinal hernia repair in former preterm infants is suggested to avoid life-threatening respiratory complications known to occur after general anaesthesia. Caudal anaesthesia is becoming a more popular technique for this purpose. ⋯ The first was uneventful with bupivacaine 0.25% at 35 weeks postconceptional age. At 38 weeks, the baby suffered form intra- and postoperative apnoeas after inadvertent administration of bupivacaine 0.125% plus clonidine.
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Paediatric anaesthesia · Sep 2002
Is there a role of a small dose of propofol in the treatment of laryngeal spasm?
Propofol has been found to depress the laryngeal reflexes. We studied whether this property could be utilized to relieve laryngeal spasm. ⋯ Propofol in a small dose (0.8 mg.kg-1 body weight) was a useful drug to relieve laryngeal spasm in most children (76.9%) following the removal of the LMA. Because it was not found to be effective in all patients, succinylcholine still has a role to play in critical conditions. However, we recommend propofol as a suitable alternative for relieving laryngeal spasm in situations where succinylcholine is contraindicated.