ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00215.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00216.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryNinety‐eight measurements were made to evaluate the level of pollution by halogenated anaesthetics, in 27 operating rooms of 12 hospitals in the Paris area. Air sampling was made during ordinary work sessions to evaluate the degree of personal pollution to which different members of the operating room staff were exposed. Samples were analysed by gas chromatography. The degree of personal pollution was particularly high in hospitals devoted to paediatric surgery. Anaesthetists were most at risk. Scavenging equipment and a large volume of air in the operating room helped in a reduction in the level of pollution. A high rate of air extraction and the use of a filter appeared to be necessary to reduce pollutio

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00217.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryA series of 52 thoracic and/or upper abdominal computer tomography scans were reviewed in order to determine the optimal puncture site and depth for performing paravertebral blocks in the mid‐thoracic region in children and adolescents. Both the lateral distance from the spinous process to the paravertebral space (SP‐PVS distance) and the depth from the skin to the paravertebral space (S‐PVS depth) correlated well (rvalues 0.86–0.95) to all patient related parameters (age, height, weight and body surface area). Since patient weight is usually readily obtainable and correlates well with both SP‐PVS distances (r= 0.89; SP‐PVS distance (mm) = 0.12 x body weight (kg) + 10.2) and S‐PVS depth (r= 0.95; S‐PVS depth (mm) = 0.48 x body weight (kg) + 18.7) this parameter might provide the best and easiest prediction of the location of the paravertebral space when performing paravertebral blocks in children

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00218.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryPropacetamol is a soluble injectable form of paracetamol, which is quickly hydrolysed after intravenous injection. We report the pharmacokinetic results of this drug in children between 10 months and 14 years of age. Three minutes after an i.v. administration of 15 mgkg‐1the mean plasma paracetamol concentration was about 25 μgml‐1. In a course of repeated administration of propacetamol, the plasma concentration 3 min after the fourth dose remained at about the same value, showing that there was no accumulation of paracetamol. The pharmacokinetic parameters (half life, total clearance and distribution volume) were similar to those in adults. At 15 mgkg‐1doses, the antipyretic effect is well‐est

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00219.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryBronchoscopy was performed in 161 patients with oesophageal atresia or tracheo‐oesophageal fistula without atresia between 1983 and 1991 at The Children's Hospital, Cologne, Germany. Twelve patients had oesophageal atresia without fistula, and seven patients had tracheo‐oesophageal fistula without atresia. In the 149 patients with congenital tracheo‐oesophageal fistula a total of 154 fistulae were found. In the five patients with two fistulae the second was detected in one patient only during primary anastomosis, and in the other four patients by bronchoscopy up to 18 years after the original operation.The study group comprised 113 newborn infants and 48 patients admitted for evaluation of severe airway problems. A very high proportion (89%) of the newborn infants had an associated abnormality of the respiratory tract. In the other 48 patients, all showed a tracheobronchial abnormality. Fourteen of these patients required tracheal surgery and 12 improved following oesophageal surgery. A comparison between the incidence of the types of oesophageal atresia previously described and this series showed a marked difference, which is probably due to greater precision of the location of the fistula demonstrated by bronchoscopy. Bronchoscopy should be undertaken in all patients with oesophageal atresia with a tracheo‐oesophageal

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00220.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryIn paediatric epidural anaesthesia, the distance from the skin to the epidural space is of special importance because of the great differences in size of the patients. We measured the distance from the skin to the lumbar epidural space (L3/4) in 355 paediatric patients. The epidural space was punctured using a midline approach under general anaesthesia, and was identified by the micro‐drip infusion technique. There was a good correlation between the distance to the epidural space and body weight.A clinically useful formula for estimating the distance from the skin to the lumbar epidural space was derived as follows:D = (W+10) × 0.8where D = distance from the skin to the lumbar epidural space (L3/4) (mm) and W = body weight (k

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00221.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryMidazolam sedation may offer an alternative to general anaesthesia for dental treatment in children. This study evaluated the efficacy and safety of i.v. midazolam with local anaesthesia in uncooperative paediatric dental patients. Thirty children (aged 2–10 years, physical status ASA 1 or 2) were randomized into two groups to receive general anaesthesia (group G) or local anaesthesia during sedation with i.v. midazolam (group M). Incremental doses of midazolam 0.05 mgkg‐1were given to a sedative endpoint of 2 on a Sedation Scale of 5–0 (hyperactive–asleep), or 0.4 mgkg‐1maximum, then as needed to maintain the same level of sedation. Amnesia was tested at the sedative endpoint by showing the child a tinkling ball and checking recall 1 h after surgery. Recovery was assessed by the Post‐Anesthetic Recovery Scale at 3 h (0–10) with 10 representing readiness for discharge. Questionnaires were completed by the dentist and anaesthetist during recovery and by telephone to the parents 1–2 weeks later. Dental treatment was completed according to protocol in 11 of the 15 patients in group M (sedative doses: 0.27 0.09 mgkg‐1, mean SD) and all patients in group G. Recovery was similar in both groups, with discharge criteria met after 1 h 30 min in all but one group M patient. None had recall for intra‐operative events. However, the variability of responsiveness makes midazolam unreliable when used alone to facilitate dental treatment, and the high dose requirements make close monitoring of paediatric

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00222.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThe mucopolysaccharidoses present many potential difficulties to the anaesthetist. A review was undertaken of the last 10 years' experience at a paediatric hospital which has a special interest in the treatment of these conditions using bone marrow transplantation. Thirty‐five patients underwent 150 general anaesthetics. There was a high incidence of airway problems and cardiorespiratory disease. Laryngoscopy and tracheal intubation was difficult in 40% of patients with Hurler's syndrome and 71% of those with Hunter's syndrome. A tracheal tube of smaller than predicted internal diameter was commonly required. Cardiorespiratory problems included both myocardial and valvular disease which could often be identified preoperatively as could kyphoscoliosis. The implications for anaesthesia are discusse

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00223.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryWe present a case of a retained sheared caudal catheter in which catheter retrieval was elected and performed with an uneventful recovery.

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00224.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY