Anaesthesia
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Arterial oxygen saturation was measured by pulse oximetry in 105 children (aged 2 weeks-14 years) during recovery from general anaesthesia. Oxygen saturation was monitored continuously from the time that anaesthesia ended in the operating theatre until the children were fit to leave the recovery ward. All children breathed room air during transfer to the recovery area; 81 children continued to breathe room air in the recovery ward while the remainder received supplementary oxygen. ⋯ The administration of 100% oxygen at the end of anaesthesia had no effect on the incidence of early hypoxaemia which was greatest in children whose trachea had been intubated. Late hypoxaemia was associated most commonly with crying and breath-holding and was reduced significantly by supplemental oxygen. The oxygen saturation of children on return to the ward was significantly lower than the pre-operative value (p less than 0.001).
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Randomized Controlled Trial Comparative Study Clinical Trial
Anaesthetic induction with isoflurane or halothane. Oxygen saturation during induction with isoflurane or halothane in unpremedicated children.
The authors performed a randomised, prospective trial in which one junior anaesthetist administered gaseous induction of anaesthesia to 50 unpremedicated children with either isoflurane or halothane in nitrous oxide and oxygen. Arterial oxygen saturation and the electrocardiogram were monitored and the incidence of complications noted. ⋯ Coughing, movement, laryngospasm and sinus tachycardia occurred more frequently with isoflurane. Isoflurane inductions took longer (7.9 as compared with 5.4 minutes, p less than 0.001) and had 4.25 times the number of complications.
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Randomized Controlled Trial Clinical Trial
Postoperative recovery after general anaesthesia with and without retrobulbar block in retinal detachment surgery.
This study was to determine whether general anaesthesia plus retrobulbar block would be a better anaesthetic technique than general anaesthesia alone in retinal detachment surgery. Twenty-eight patients were allocated randomly to either general anaesthesia with retrobulbar block or general anaesthesia alone. The anaesthetist involved was blinded as to whether a retrobulbar block was performed or not. ⋯ Those who received general anaesthesia plus block recovered significantly more rapidly than those receiving general anaesthesia alone. The time to opening of eyes on command (p less than 0.05), telling the correct date of birth (p less than 0.01), reaching a full recovery score (p less than 0.005) and performing a simple motor task (p less than 0.025) was shorter in patients with general anaesthesia plus block. Thus general anaesthesia plus retrobulbar block was superior to general anaesthesia alone in terms of pain and recovery after operation.
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In a study of 144 children aged 1-12 years, attempts were made to assess the ED50 and ED90 of the intravenous induction agent, propofol. The doses required for loss of eyelash reflex and tolerance of facemask, in 50% of unpremedicated children, were 1.6 mg/kg and 2.5 mg/kg respectively. ⋯ This probably corresponds to an effective induction dose. Pain and movement on induction were common; the incidence was 27% and 21.5% respectively.