Minerva anestesiologica
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A suitable perioperative fluid therapy during paediatric anaesthesia presupposes a valuation of renal function and the preoperative fluid and electrolyte imbalance, a precise knowledge of fluid requirements and the physiological stress responses to surgery in different paediatric groups. Fluid administration must be suited to the pathology of the patients and surgical approach. ⋯ In order to prevent the dangers from blood transfusions you need to estimate the intraoperative loss and follow the "acceptable hematocrit" values. Rational intraoperative fluid management reduces perioperative morbidity and mortality.
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Minerva anestesiologica · Apr 1996
[Sedation, combined anesthesia, and total intravenous anesthesia (TIVA) with propofol in the pediatric surgical patient].
Total intravenous anaesthesia (TIVA) has recently obtained a wide diffusion in paediatrics, thanks to the pharmacological properties of propofol. The authors make a review on sedation, combined anaesthesia and Tiva in paediatric anesthesia, particularly on propofol and its characteristics. They describe the practical use of TIVA with recent knowledge in this field.
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The response to muscle relaxants and the dose required change during growth from birth to adolescence. Some physiological factors such as development of neuromuscular junction, the different distribution of the muscle fibres, and the extracellular fluid compartment affect the non depolarizing muscle relaxant (NDMR) ED 95, onset time and recovery time. Infants under 1 year of age are more sensitive to the NDMR and need less drug; children aging more than 1 year are more resistant and need a larger amount of drug; the reversal of the neuromuscular blockade before extubation, is extremely important especially in infants with long-acting agents.