Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Clinical TrialConvective warming blankets improve peroperative heat preservation in congenital heart surgery.
Peroperative heat preservation, following hypothermic cardiopulmonary bypass (CPB) in children, has always been a challenge to the anaesthetist. We studied the efficiency of a convective heating system on peroperative heat preservation in 50 children undergoing congenital heart surgery. Twenty-five children, rewarmed by CPB and heating mattress, were randomly selected (Group 1). ⋯ At the end of bypass there was no significant difference between the two groups. At the end of operation the central and peripheral temperatures were significantly higher in Group 2. In conclusion convective warming blankets are effective in keeping or even raising the temperature following congenital heart surgery.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Comparative Study Clinical TrialA double blind comparison of droperidol and ondansetron for prevention of emesis in children undergoing orthopaedic surgery.
Emesis is common in the postoperative period following epidural opioid and general anaesthesia. Eighty patients ages two to 14 years scheduled for major orthopaedic surgery were enrolled in a randomized, double-blind study to compare the prophylactic effects of ondansetron, droperidol and a placebo for the prevention of postoperative emesis. Each child was assigned at random to one of the four treatment groups: ondansetron 100 micrograms.kg-1, ondansetron 50 micrograms.kg-1, droperidol 60 micrograms.kg-1 and saline control. ⋯ Ondansetron (50 micrograms.kg-1) and droperidol groups had lower incidence of PONV compared to the control group. The ondansetron (100 micrograms.kg-1) group had a significant decrease in the incidence of emesis. We conclude that the prophylactic administration of ondansetron (100 micrograms.kg-1) is more effective than droperidol and ondansetron (50 micrograms.kg-1) and superior to saline (P < 0.02) for the prevention of emesis before epidural opioid and general anaesthesia.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Clinical TrialTranscutaneous CO2 tension effects of clonidine in paediatric caudal analgesia.
In adults, clonidine when added to bupivacaine, results in no detectable respiratory depressant effect except when carbon dioxide challenge is performed. However, to date no investigations have quantified this in children. Twenty-four children (nine months to seven years) were randomized in a double-blind study into two groups. ⋯ The sedation score decreased with time in both groups, and the score time interval was significantly higher in the clonidine group (P < 0.05). All the patients left the recovery room with a sedation score of 1, excepting four in the clonidine group with a sedation score of 2. Clonidine 1 microgram.kg-1 with 0.25% bupivacaine mixture in caudal analgesia in children did not induce an increase in tcPCO2 despite prolonged sedation.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Clinical TrialEarly intravenous cannulation in children during inhalational induction of anaesthesia.
Intravenous cannulation is obtained in almost all patients scheduled for operative intervention under anaesthesia. In our practice, inhalational induction precedes cannulation in children in order to avoid pain and discomfort, and cannulation is delayed until the child is adequately anaesthetized in fear of precipitating laryngospasm due to painful stimulus of venepuncture in the light stage of anaesthesia. ⋯ There was no significant differences in the incidence of laryngospasm or in the success rate of intravenous cannulation between the two groups. We conclude that venous cannulation can be safely performed during the light stages of anaesthesia.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Clinical TrialThe advantages of intrathecal opioids for spinal fusion in children.
Two groups of 40 homogeneous patients (ASA physical status (1-2)) with idiopathic scoliosis undergoing spinal fusion with CD instrumentation were studied prospectively. Group A (intrathecal) received a mixture of morphine and sufentanil administered intrathecally at the level of L3-L4 after the induction of anaesthesia. Group B (control) had inhalation and intravenous narcotic anaesthesia. ⋯ The dose requirement for the anaesthetic agents was significantly reduced and the blood loss was 27% of their blood volume compared with 53% in the control group. No long or short term impairment of cerebral or spinal function was observed. The use of intrathecal opioids supplemented with other anaesthetic agents is an alternative method with multiple benefits for any major surgery such as spinal fusion.