Anaesthesia
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Case Reports
Ketamine, midazolam and vecuronium infusion. Anaesthesia for Down's syndrome and congenital heart disease.
A ketamine, midazolam and vecuronium infusion was used for total intravenous anesthesia in a patient with Down's syndrome, a ventricular septal defect and pulmonary hypertension. A mixture of ketamine 200 mg, midazolam 5 mg and vecuronium 12 mg in 50 ml of normal saline was infused at 0.5 ml/kg/hour. This simple technique and ventilation with 100% oxygen maintained tissue oxygenation and cardiovascular stability.
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An assessment of local anaesthetic blockade of the lateral femoral cutaneous nerve using a standard technique was made. The rate of successful blockade was high, but the area of sensory loss was inconsistent between patients and was more anterior and distal than described in textbooks of anatomy.