Der Anaesthesist
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Case Reports
[Patient-controlled analgesia. PCA in a three year old child after traumatic amputation].
We report the case of a 3-year-old boy, who received long-term parent-controlled analgesia after traumatic amputation of one leg. He underwent surgery 17 times for a period of 25 days. Parent-controlled analgesia was started four days after admission because analgesia with non-opioid analgetics (acetaminophen) proved to be insufficient. ⋯ Feasibility was shown in adolescents and, more recently, in children aged five years and over. Only few reports are available describing long term use of PCA in children younger than five years. Our case suggests that PCA may also be used effectively and safely in children younger than five years, if experienced staff, a monitoring regimen and cooperative and well instructed parents are available.
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Review Historical Article
[Nitrous oxide. Trends and current importance].
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Since its introduction in clinical use more than ten years ago, propofol is well appreciated for sedation and supplemental hypnosis in anaesthesia. However the substance is approved only for anaesthesia in children elder than three years. As can be substantiated by many data reported in literature, there are no pharmacokinetic or pharmacodynamic reasons whatsoever to withhold propofol from the younger children; this applies both to the use as a narcotic supplement and as a short term hypnotic for diagnostic and therapeutic interventions.