Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2001
Randomized Controlled Trial Clinical TrialBispectral index monitoring during infant cardiac surgery: relationship of BIS to the stress response and plasma fentanyl levels.
We evaluated the relationship of the bispectral index (BIS) to commonly used indices of depth of anaesthesia in 19 infants enrolled in a prospective study of the stress response to hypothermic cardiopulmonary bypass. ⋯ We were unable to demonstrate a relationship between the BIS and haemodynamic, metabolic or hormonal indices of anaesthetic depth. Further evaluation of the BIS algorithm is required in neonates and infants.
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Paediatric anaesthesia · Nov 2001
Comparative StudyRegional anaesthesia decreases the need for postoperative mechanical ventilation in very low birth weight infants undergoing herniorrhaphy.
We were interested to know whether regional anaesthesia allowed improved respiratory function postoperatively in very low birth weight babies. ⋯ Regional anaesthesia decreases the need for postoperative ventilatory support requirements in very low birth weight infants undergoing herniorrhaphy.
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Clinical experience with anaesthesia for a series of patients with Apert syndrome (craniosynostosis, midface hypoplasia and syndactyly) has not been reported previously. ⋯ We could not demonstrate any benefit from preoperative administration of nebulized albuterol. Paediatric anaesthetists should be aware of this high incidence of respiratory complications in Apert syndrome.
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Paediatric anaesthesia · Nov 2001
Case ReportsThe anaesthetic management of a deliberately created bronchoatmospheric fistula in bilateral pulmonary hydatids.
Postoperative empyema and bronchopleural fistula are well known complications after surgery for pulmonary hydatid disease. The pneumonostomy technique of deliberately creating a bronchoatmospheric fistula after removal of the parasite has been used to prevent these complications. This technique, however, is an added anaesthetic challenge, especially if the child presents again for surgery before this fistula has healed. We describe the anaesthetic management of such a case where controlled increase of the resistance to the air leak via the fistula during intermittent positive pressure ventilation helped circumvent these problems.