Paediatric anaesthesia
-
Paediatric anaesthesia · Nov 2001
Critical incidents in paediatric anaesthesia: an audit of 10 000 anaesthetics in Singapore.
We undertook an audit of paediatric perioperative incidents in the first 10000 anaesthetics administered in KK Women's and Children's Hospital in Singapore between May 1997 and April 1999. The spectrum of surgery performed ranged from simple ambulatory surgery to open heart surgery for complicated congenital heart diseases. ⋯ Future reviews of a larger patient population may be helpful to determine trends of perioperative events and whether quality assurance programs have made a difference.
-
Paediatric anaesthesia · Nov 2001
Case ReportsUse of rapacuronium in a child with spinal muscular atrophy.
We report the case of an 18-month-old girl with spinal muscular atrophy (SMA) that received 1 mg x kg(-1) rapacuronium for laryngospasm during induction of anaesthesia. Within 15 min, we observed some diaphragmatic recovery and, after emergence from anaesthesia, the child demonstrated adequate respiratory efforts. However, the child showed diminished strength of the upper extremity muscles. ⋯ Train of four (TOF) monitoring of the right adductor pollicis muscle, performed during anaesthetic recovery, was equivocal. In SMA, muscle groups are differentially affected so that TOF responses may be inconclusive and not reflect the state of the upper airway muscles. To our knowledge, this is the first report of use of a nondepolarizing neuromuscular blocking agent in a child with SMA.