Paediatric anaesthesia
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Clinical TrialTracheal intubation without neuromuscular blockade in children: a comparison of propofol combined either with alfentanil or remifentanil.
Forty healthy children, aged between two and 12 years of age undergoing elective surgery where the anaesthetic technique involved tracheal intubation followed by spontaneous ventilation were studied. Induction of anaesthesia was with either alfentanil 15 micrograms.kg-1 or remifentanil 1 microgram.kg-1 followed by propofol 4 mg.kg-1 to which lignocaine 0.2 mg.kg-1 had been added. Intubating conditions were graded on a four point scale for ease of laryngoscopy, vocal cord position, degree of coughing, jaw relaxation and limb movement. ⋯ There were no significant differences in the assessments of intubating conditions between the two groups. Arterial blood pressure and heart changes were similar in the two groups with both alfentanil and remifentanil attenuating the haemodynamic response to tracheal intubation. The time taken to resumption of spontaneous ventilation was similar in both groups.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Clinical TrialThe effect of nitrous oxide diffusion on laryngeal mask airway cuff inflation in children.
We studied the effect of nitrous oxide (N2O) diffusion on size 2 LMA cuff inflation in 52 children, 38 +/- 21 months of age. LMA cuffs were inflated with air (Group A) or 65% N2O, oxygen and halothane (Group B). ⋯ Cuff leak pressure did not change significantly in either group. We conclude that cuff inflation with a mixture of N2O/oxygen prevents N2O diffusion into the cuff, avoiding cuff overinflation without compromising LMA function.
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Paediatric anaesthesia · Jan 1998
Comparative StudyStridor in the neonate and infant. Implications for the paediatric anaesthetist. Prospective description of 155 patients with congenital and acquired stridor in early infancy.
One hundred-and-fifty-five neonates and infants up to the sixth month of postnatal age were investigated to reveal the cause of clinically relevant stridor. In 100 patients congenital stridor was found, in 55 children the stridor was considered to be acquired. A curled, soft epiglottis, almost synonymously used with the diagnosis of congenital stridor, was found in 7% only, indicating different methods of investigation and different selection of patients compared to previous years. In acquired stridor the majority of infants showed laryngeal and tracheal trauma, mostly due to the use of too large tracheal tubes.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Clinical TrialModifying infant stress responses to major surgery: spinal vs extradural vs opioid analgesia.
Twenty-six infants due to undergo major abdominal or thoracic surgery under general anaesthesia were randomized to receive additional analgesia with group A) spinal/epidural analgesia; B) epidural analgesia or C) opioid analgesia with fentanyl. We wished to determine if spinal analgesia followed by epidural analgesia might result in more complete control of cardiovascular or stress responses than the other two treatment groups. Heart rate and blood pressure were recorded at five min intervals throughout surgery. ⋯ Systolic blood pressures were higher in group C compared to A and B. The rise in plasma glucose concentrations was significantly different between the groups in the order C > B > A (P < 0.05). A similar trend was seen in the plasma adrenaline and noradrenaline concentrations but this failed to achieve significance due to the limited sample size.
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Paediatric anaesthesia · Jan 1998
Randomized Controlled Trial Clinical TrialPrevention of halothane-induced bradycardia: is intranasal premedication indicated?
Eighty ambulatory surgical patients with ASA physical status 1 and 2, aged 1-10 years, were studied. One group received intranasal (IN) midazolam 0.25 mg.kg-1; a second group received IN 0.25 mg.kg-1 of midazolam plus 0.02 mg.kg-1 of atropine; the third group received 0.25 mg.kg-1 of midazolam plus 0.02 mg.kg-1 of atropine administered intramuscularly, and the fourth group received IN saline drops. ⋯ Children receiving midazolam had better preoperative sedation and anaesthesia induction scores. The IN administration of neither midazolam alone nor midazolam-atropine altered the incidence or degree of halothane-induced bradycardia.