Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1988
ReviewIs there a place for regional anesthesia in pediatrics?--Yes!
Regional anesthesia has a central place in pediatrics. The neonate requires an analgesic, but not one which will produce respiratory depression. The older child undergoing intermediategrade surgery requires the best available analgesia, but without sedation and nausea. ⋯ Caudal block is particularly useful and, even when given in large doses, does not give rise to high plasma concentrations. Regional techniques are seen at their best when combined with light general anesthesia. The advantages of both these methods are then available for the benefit of the child, and the value of regional analgesia is further enhanced when supplementary intramuscular or oral analgesia is given regularly at specific times so that pain is prevented rather than relieved.
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Acta Anaesthesiol Belg · Jan 1988
Review Comparative StudyThe relevance of immunologic responses to anesthesia and surgery.
Out of some three million general anesthetic (GA) procedures administered in the UK each year some 10,000 patients will suffer clinically a severe immediate hypersensitivity-type (anaphylactoid) response: some will suffer neurological deficit, a few will die. The problems are essentially those intrinsic to all intravenous administration and infrequently drug specific. ⋯ The relative incidence of severe LA to GA reactions reported nationwide to Sheffield lies between 5% and 10% of the total reports. In the post-operative period the dramatic changes in laboratory parameters of immunity refer largely to the stress response to surgery and probably have little relevance to post-operative infection and wound healing in elective surgery.
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Acta Anaesthesiol Belg · Jan 1988
ReviewNo decisive break-through yet for general anesthesia combined with locoregional anesthesia!
Although on theoretical grounds locoregional anesthesia, because of the claimed suppression of stress response and the ease with which prolonged analgesia can be achieved, seems preferable to general anesthesia, the shortcomings and drawbacks are such that its use is restricted to well chosen indications. The hope that combination anesthesia can overcome the limitations of both techniques remain to be proven whereas the problems that can arise during the combined technique could pose a major threat to the patient.