Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2001
Randomized Controlled Trial Comparative Study Clinical TrialComparison of recovery after intermediate duration of anaesthesia with sevoflurane and isoflurane.
The purpose of this study was to compare recovery from anaesthesia after sevoflurane and isoflurane were administered to children for more than 90 min. ⋯ After intermediate duration of anaesthesia administered to children for up to 90 min, isoflurane and sevoflurane allow recovery after approximatively the same lapse of time.
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Paediatric anaesthesia · Jul 2001
Assessment of pain by parents in young children following surgery.
We asked parents to assess pain in young children following surgery. ⋯ Our findings suggest that parents can assess pain in young children following surgery. The management of pain following discharge from hospital can be improved.
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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.
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Autistic children are very difficult to manage in the hospital setting because they react badly to any change in routine. ⋯ There is great variation in the severity of autism and hospital needs of these children. The focus is on early communication with the patient's families, flexibility to individualize the admission process and anaesthetic plan with admission and early discharge on the day of surgery whenever possible. Oral midazolam is an effective premedication for the milder cases and oral ketamine is the most reliable for moderate and severe cases. Comparison of oral midazolam and ketamine shows no significant different postoperative recovery and hospital discharge times. Routine intravenous fluids and antiemesis prophylaxis with removal of the i.v. cannula before return to the ward are also seen as important steps to decrease stress and smooth the postoperative phase. This program has also successfully been extended to the management of problem children due to other causes.