Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1999
Randomized Controlled Trial Clinical TrialPrevention of postoperative vomiting with granisetron in paediatric patients with and without a history of motion sickness.
A history of motion sickness is one of the patient-related factors associated with postoperative emesis. This prospective, randomized, double-blind, placebo-controlled study was undertaken to assess the efficacy of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, for preventing postoperative vomiting after tonsillectomy in 120 children with (n = 60) and without (n = 60) a history of motion sickness. ⋯ No clinically serious adverse effects due to the study drug were observed in any of the groups. In conclusion, prophylactic antiemetic therapy with granisetron is effective for preventing postoperative emesis in children with a history of motion sickness as well as in those without it.
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Paediatric anaesthesia · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialComparison of epidural morphine, hydromorphone and fentanyl for postoperative pain control in children undergoing orthopaedic surgery.
The safety and side-effects profile of epidural administration of a hydrophilic (morphine), highly lipophilic (fentanyl) and a drug with intermediate hydrophilic and lipophilic activity (hydromorphone) were compared in 90 children undergoing orthopaedic procedures. Ninety patients were randomly assigned (30 in each group) to receive epidural morphine, hydromorphone, or fentanyl for postoperative analgesia. Respiratory effects, nausea, somnolence, urinary retention, pruritus and visual pain scales were evaluated and compared during a 30-h period following surgery. ⋯ Statistically, there was no significant difference in nausea between the groups, but pruritus was more severe and frequent in the morphine group. The incidence of urinary retention in the morphine group was higher compared with the fentanyl and hydromorphone groups. In conclusion, epidural hydromorphone, demonstrating less side-effects, is preferable to morphine and fentanyl for epidural analgesia in children.
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Paediatric anaesthesia · Jan 1999
Randomized Controlled Trial Clinical TrialOliguria during corrective spinal surgery for idiopathic scoliosis: the role of antidiuretic hormone.
Patients undergoing surgery for idiopathic scoliosis were studied to determine the incidence and aetiology of oliguria during the perioperative period and to evaluate the efficacy of low dose dopamine in preventing its occurrence. Thirty patients, aged 6-18 years undergoing elective surgery were studied. Anaesthesia was standardized. ⋯ Serum ADH concentrations were increased in both groups (P < 0.05), returning to baseline 18 h postoperatively. We conclude that oliguria during corrective spinal surgery occurs in association with excess ADH secretion as opposed to perioperative hypovolaemia. Dopamine increases urine output in the perioperative period but does not prevent the release of ADH and its subsequent biochemical effects.
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Paediatric anaesthesia · Jan 1999
Case ReportsExtrapyramidal side-effects from droperidol mixed with morphine for patient-controlled analgesia in two children.
We report two cases of extrapyramidal reactions occurring in children following the use of droperidol in combination with morphine for patient-controlled analgesia (PCA). Symptoms appeared 38 and 27 h, respectively, after commencement and after a total dose of 0.14 mg.kg-1 and 0.17 mg.kg-1, respectively. Although effective and safe in adult patients, we recommend caution with the use of droperidol-morphine mixtures for PCA in paediatric patients.
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Paediatric anaesthesia · Jan 1999
Postal survey of the anaesthetic techniques used for paediatric tonsillectomy surgery.
A postal survey of anaesthetic techniques used for tonsillectomy surgery in children (age 3-16 years) was performed with particular reference to the use of the reinforced laryngeal mask airway and the use of suxamethonium. From 110 questionnaires despatched, replies were obtained from 88 consultant anaesthetists with commitments to otolaryngologic (ENT) anaesthesia (response rate 80%). ⋯ Suxamethonium was used routinely by 40 consultants (45%) for tonsillectomy surgery. Severe problems with its use had been encountered by 26 (30%) respondents