Paediatric anaesthesia
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Paediatric anaesthesia · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialA prospective randomized controlled study of the efficacy of ketamine for postoperative pain relief in children after adenotonsillectomy.
Adenotonsillectomy is commonly needed by children with obstructive sleep apnoea syndrome. This population is at high risk of life threatening airway obstruction in the postoperative period. ⋯ Ketamine is a safe and effective alternative to morphine to provide analgesia in the immediate postoperative period after tonsillectomy.
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Paediatric anaesthesia · May 2001
Comparative Study Clinical TrialAccuracy and limitations of continuous oesophageal aortic blood flow measurement during general anaesthesia for children: comparison with transcutaneous echography-Doppler.
Because it is noninvasive and easy to use, oesophageal Doppler ultrasonography appears to be a worthwhile alternative for continuous assessment of cardiac output measurement during anaesthesia. A new oesophageal Doppler-echography device (Dynemo 3000, Sometec, Paris, France) can simultaneously determine aortic diameter and aortic blood flow at the same anatomical level (DEeso). The purpose of this study was to assess the accuracy and the potential limitations of this device during general anaesthesia among 20 children, using transcutaneous Doppler-echocardiography for comparison (DEtra). ⋯ These results suggest that this new oesophageal Doppler method is unsuitable to measure accurately absolute CO values and relative CO changes in children during anaesthesia.
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Paediatric anaesthesia · May 2001
Clinical TrialThe prone position is associated with a decrease in respiratory system compliance in healthy anaesthetized infants.
Ten healthy (ASA I or II) anaesthetized infants undergoing clubfoot surgery were studied. General anaesthesia included rocuronium, nitrous oxide and isoflurane. Volume controlled ventilation (12 ml.kg-1) was delivered via a coaxial Mapleson-D (Bain) system and a Datex AS/3 ventilator. ⋯ Mean CDYN decreased from 14.9 +/- 4.9 ml.cmH2O-1 (supine) to 11.6 +/- 3.5 ml.cmH2O-1 (prone). Mean CSTAT decreased from 10.2 +/- 2.8 ml.cmH2O-1 (supine) to 8.9 +/- 2.3 ml.cmH2O-1 (prone). No clinically significant differences in gas exchange were noted, however, on repositioning.
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Paediatric anaesthesia · May 2001
Parents' preferences for participation in decisions made regarding their child's anaesthetic care.
The traditional paternalistic approach to medical decision-making is moving towards a climate of greater patient and/or surrogate involvement. Despite this, there is considerable debate regarding patient preferences for participation in medical decision-making and its effect on patient satisfaction and outcome. This study was designed to examine parents' preferences for participation in decisions regarding their child's anaesthetic care and to determine if active participation is associated with greater parental satisfaction. ⋯ This study highlights specific areas in which parents would prefer a more active role in decision-making and, as such, may serve to focus anaesthetists' efforts to educate parents with respect to the various options available for their child's care.
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Paediatric anaesthesia · May 2001
Teaching and supervising tracheal intubation in paediatric patients using videolaryngoscopy.
In 85 patients (mean age 4.6 +/- 3.1 years, range 0-10 years), a prototype of a new videolaryngoscope was used to provide a display of the intubation procedure in a paediatric anaesthesia teaching unit. The device provided important information to the teacher about the trainee's problems related to direct laryngoscopy, difficulties with tube insertion into the larynx as well as the need and extent for anterior laryngeal pressure. Because the videolaryngoscope did not impair the normal intubation procedure, it seems to be a safe and a benefical tool for teaching and supervising tracheal intubation in children. In addition, it provides a potentially useful aid during difficult laryngoscopy, since the monitor view of the vocal cords was significantly better compared with a direct laryngoscopic view (P < 0.001).