Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2001
Evaluation of caudal anaesthesia performed in conscious ex-premature infants for inguinal herniotomies.
Ex-premature infants, before 45 weeks postconceptional age, are at high-risk of apnoea after surgery. General anaesthesia increases the risk of apnoea. We evaluated the tolerance and the efficiency of caudal anaesthesia performed in 25 consecutive conscious ex-premature infants for inguinal herniotomies. ⋯ The principal advantage of the procedure is to facilitate and simplify the postoperative management of the babies. The anaesthetic technique does not alter surgical conditions. Caudal epidural anaesthesia performed in awake high-risk preterm infants is beneficial for these infants but requires experienced operators.
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Paediatric anaesthesia · Jan 2001
Fibreoptic nasal intubation in children with anticipated and unanticipated difficult intubation.
The establishment of a tracheal airway with direct laryngoscopy can be either a very difficult or an impossible task in children with congenital or acquired facial malformations. Out of 46 patients categorized as difficult tracheal intubation, fibreoptic laryngoscopy was used successfully in 44 children anaesthetized by mask with sevoflurane and oxygen or by an intravenous infusion of propofol and mask oxygenation. There were two failures (4.3%). ⋯ Fibreoptic laryngoscopy was successful in 37 cases (80.4%) on the first attempt to intubate and in seven (15.2%) on a second or third attempt. We conclude that fibreoptic laryngoscopy in anaesthetized children with difficult anticipated or unanticipated tracheal intubation in trained hands is a safe technique that can be lifesaving. Therefore, we urge all anaesthesia trainees to become proficient in fibreoptic tracheal intubation.
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Paediatric anaesthesia · Jan 2001
Clinical predictors of anaesthetic complications in children with respiratory tract infections.
Details of the preoperative condition, in particular symptoms of respiratory tract infections (RTI), perioperative management and the occurrence of perioperative complications, were collected in a survey of 2051 children. Logistic regression was used to determine which variables were predictors of anaesthetic adverse events. 22.3% of the children had symptoms of an RTI on the day of surgery, and 45.8% had a 'cold' in the preceding 6 weeks. Logistic regression returned eight variables. ⋯ Orotracheal intubation was associated with an increased probability of complications when compared with laryngeal mask airway and facemask. RTI in the preceding 6 weeks did not increase probability of complications. Wheeze, fever, malaise and age could not be excluded as predictors in this study because children with these symptoms and infants with colds were effectively excluded from the study.
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Paediatric anaesthesia · Jan 2001
Case ReportsThe difficult paediatric airway: a new method of intubation using the laryngeal mask airway, Cook airway exchange catheter and tracheal intubation fibrescope.
We describe a new technique of intubation for use in difficult paediatric airway cases utilizing the laryngeal mask airway, a Cook Airway Exchange Catheter and a paediatric intubation fibrescope. This method has a number of potential advantages over previously described methods.