Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2000
Randomized Controlled Trial Clinical TrialAxillary block in children: single or multiple injection?
The goal of this double-blind prospective study was to compare the effect of a single injection versus multiple fractionated doses on the onset time and quality of motor and sensory block, obtained in 70 children anaesthetized with axillary block alone. The brachial plexus was identified with a peripheral nerve stimulator, and blocked with 0.5 ml.kg-1 of 1.5% lignocaine with adrenaline. In Group S (single injection), the total volume was injected after location of one nerve. ⋯ No adverse effect was observed and analgesia was prolonged for more than 4 h. We can conclude that, unlike adults, fractionated doses in chilren bring no benefit to the quality of sensory and motor block. Selective block of the musculocutaneous nerve is recommended when a surgical procedure takes place in this territory.
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Paediatric anaesthesia · Jan 2000
Randomized Controlled Trial Comparative Study Clinical TrialComparison of ropivacaine 0.1% and 0.2% with bupivacaine 0.2% for single-shot caudal anaesthesia in children.
We compared analgesic efficacy and degree of motor block induced by ropivacaine 0.1% (R 0.1) and 0.2% (R 0.2) vs. bupivacaine 0.2% (B 0. 2) after caudal anaesthesia in children. Total and free plasma concentrations were measured after caudal injection. Duration of caudal analgesia (median/range) was significantly shorter in group R 0.1 (1.7 h/0.2-6 h) than in group R 0.2 (4.5 h/1.7-6 h) or group B 0. 2 (4 h/1-6 h) (P<0.05). ⋯ Peak plasma concentrations after ropivacaine 0.2% were higher and protein binding lower than after bupivacaine 0.2% (P<0.05). We conclude that caudal analgesia with ropivacaine 0.1% is less effective and of shorter duration than that of ropivacaine 0.2%, whereas ropivacaine 0.2% provides pain relief similar to bupivacaine 0.2%. Motor block in the early postoperative period is less with ropivacaine than with bupivacaine.
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Paediatric anaesthesia · Jan 2000
Randomized Controlled Trial Clinical TrialTropisetron reduces postoperative vomiting in children undergoing tonsillectomy.
In this patient, parent and investigator blinded, randomized, placebo-controlled study, children undergoing tonsillectomy (mean age 6.4 years) received either intravenous placebo (n=36) or tropisetron 0.2 mg.kg-1 up to 5 mg (n=35) at induction of anaesthesia with halothane, nitrous oxide and oxygen. Morphine and paracetamol were given in theatre for postoperative pain. ⋯ Minor side-effects occurred equally in both the placebo and active groups. Intravenous tropisetron is an effective and safe antiemetic for reducing postoperative vomiting in children undergoing tonsillectomy or adenotonsillectomy.
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Paediatric anaesthesia · Jan 2000
Computerized tomography of the lungs and arterial oxygen tension studies during apnoea in anaesthetized young lambs.
Computerized tomography (CT) of the lungs and arterial oxygen tension studies were performed during general anaesthesia in an animal model to understand changes in pulmonary atelectasis associated with anaesthesia in children during a 2 min apnoeic period. Six anaesthetized lambs were subjected to three periods of apnoea lasting 2 min each. ⋯ The results confirmed that significant background atelectasis was associated with general anaesthesia as found in adult human studies, but failed to demonstrate any increase in atelectasis during the period of induced apnoea. The decline in arterial oxygen tension in this study could be explained due to simple utilization of oxygen in keeping with physiological principles.