Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2001
Pain management in children with and without cognitive impairment following spine fusion surgery.
We compared pain assessment and management practices in children with and without cognitive impairment (CI) undergoing spine fusion surgery. ⋯ Our data demonstrate a discrepancy in pain management practices in children with and without CI following spine fusion.
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Paediatric anaesthesia · Jul 2001
Case ReportsComplicated airway management in a child with prune-belly syndrome.
We describe a 15-month-old boy with prune-belly syndrome (PBS) in whom airway management was complicated. Following an inhalation induction using sevoflurane, tracheal intubation by direct laryngoscopy proved impossible after repeated attempts. A laryngeal mask airway (LMAtrade mark) was inserted and the child had an uneventful anaesthetic course.
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Paediatric anaesthesia · Jul 2001
Case ReportsAnaesthetic management of a child with a positive family history of malignant hyperthermia for posterior fossa surgery in the sitting position.
A 6-year-old boy with a positive family history of malignant hyperthermia presented for posterior fossa craniectomy and excision of medulloblastoma. A nontriggering anaesthetic was therefore planned using infusions of propofol and remifentanil and a vapour free anaesthetic system delivering an oxygen/air mixture. The surgery was carried out with the child in the sitting position.
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Paediatric anaesthesia · Jul 2001
Case ReportsAnaesthetic management of a patient with myotonic dystrophy.
A 13-year-old boy with myotonic dystrophy underwent insertion of a percutaneous gastrostomy feeding tube under general anaesthesia. We used a laryngeal mask airway and a spontaneously breathing technique with propofol total intravenous anaesthesia. Postoperative vomiting and aspiration, 12 h after the procedure, subsequently required intubation and ventilation. We discuss the anaesthetic management of this case and review the features of the disease to be considered when contemplating anaesthesia in such patients.
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Paediatric anaesthesia · Jul 2001
Case ReportsMediastinal mass obscured by a large pericardial effusion in a child: a potential cause of serious anaesthetic morbidity.
Anaesthesia in the presence of a mediastinal mass is known to be hazardous. We report a case of a 5-year-old boy with a presumed postviral pericardial effusion presenting for pericardiocentesis under general anaesthesia. ⋯ The reasons for misdiagnosis, mechanisms for perioperative complications and optimal management are discussed. Mediastinal masses and underlying malignancy should always be considered in patients with large pericardial effusions.