ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00284.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00285.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYInfants of very low birthweight (VLBW) who underwent thoracotomy were given 2.0 mg·kg‐1of bupivacaine by the intrapleural route, and serial blood levels were taken to determine the pharmacokinetic profile in this group of babies. It was apparent that the half life was longer, clearance lower, and volume of distribution greater than in term infants. Although the drug did not reach toxic levels at this dose, caution should be observed when redosing as the accumulation of the drug may be unpredictab

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00286.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYRetrospective chart review (1978–1993) of 179 children less than age 18 (10.0 ± 3.8 SD yrs) undergoing muscle biopsy for determination of susceptibility to malignant hyperthermia provided data. One hundred and forty‐six patients received femoral and lateral femoral cutaneous nerve blocks as their primary anaesthetic. We examined age, weight, duration of surgery, time to discharge from hospital, choice and dosage of local anaesthetics, choice and dosage of sedation, postoperative pain medications, and complications. All children receiving this form of anaesthesia remained outpatients. Between 1978 and 1985 procaine (10 mg·kg‐1) with hyaluronidase or 2‐chloroprocaine (12 mg·kg‐1) provided nerve blockade; after 1985, lignocaine (6.8 mg·kg‐1), or a combination of lignocaine or mepivacaine and 2‐chloroprocaine, were the preferred agents. More recently the combination of 2‐chloroprocaine and bupivacaine has been popular. Three patients required admission to the recovery room postoperatively, due to heavy sedation. Forty‐three children (29%) received pain medication during recovery. Femoral and lateral femoral cutaneous block anaesthesia with light to moderate sedation is well tolerated in children undergoing ante

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00287.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00288.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYWe describe in a neonate an unusual epidural technique for pain control after the surgical correction of bladder exstrophy.

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00289.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYThe purpose of this study was to evaluate the effect of halothane on sinus node recovery time (SNRT). Nine children with congenital heart disease scheduled for cardiac catheterization were studied. After the routine procedure, the sinus node was paced at rates of 120, 150 and 180 beats per minute. SNRTs were measured with control conditions and under 1 MAC halothane anaesthesia. The absolute SNRT was standardized and expressed as ‘%SNRT’ and ‘Corrected SNRT (CSNRT)’. CSNRT was slightly prolonged by halothane (P= 0.042), while the %SNRT was not significantly prolonged. We conclude that the recovery function of the sinus node is relatively well preserved under 1 MAC halothane in c

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00290.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYGlycogelatin capsular suppositories containing a paracetamol slurry 40 mg·kg‐1were given PR to 20 children (12 months‐17 yrs) after major orthopaedic surgery and plasma concentrations of paracetamol measured for up to 18 h. The mean maximum concentration (Cmax) was 0.115 (SD 0.049) mmol·l‐1. Peak concentration occurred (Tmax) at 2.3 (SD 1.2) h. Mean concentration was 0.07 (SD 0.03) mmol·l‐1at six h. Apparent paracetamol clearance was 5.8 ml·min‐1·kg‐1. The plasma concentration of paracetamol associated with analgesic effectiveness in children is unknown, but antipyretic effects are seen in the range 0.066–0.130 mmol·l‐1. Paracetamol suppositories 40 mg·kg‐1given perioperatively achieve effective therapeutic antipyretic plasma concentrations within 1–2 h. The timing is coincident with the recovery phase of short duration paediatric surgery. The coefficient of variance ofCmaxwas 43%. Some individual patients may not achieve

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00291.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYUpper airway patency can be compromised when children (or adults) receive sedative medication. The study examines the effect of two different positioning techniques (use of the ‘sniff position pillow’ (SPP) and shoulder elevation (SE) on maintenance of upper airway patency using MRI in 21 children sedated with intravenous pentobarbital (5–8 mg·kg‐1). Children positioned on the SPP had a significantly greater degree of atlanto‐occipital extension (P<0.05), and a significantly greater nasopharyngeal diameter (P<0.05) than those with shoulder elevation. The degree of atlanto‐occipital extension was not significantly correlated with pharyngeal diameter (R = ‐0.68). No clinical signs of upper airway obstruction were noted and oxygen desaturation did not occur. Both positioning techniques were consistently associated with upper airway patency under the study conditions described. In obligate nose breathers to whom sedative agents are administered, the SPP is more likely to maintain nasopharyngeal patency than shou

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00292.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYWe compared the effect of a propofol‐based anaesthetic to an isoflurane‐based anaesthetic on the incidence of postoperative vomiting in children following tonsillectomy. Thirty‐nine children were enrolled in the study and randomized to receive one of the proposed anaesthetics. All patients underwent a mask induction with halothane, nitrous oxide, and oxygen. Intravenous access was established and all children received fentanyl (2–4 μg·kg‐1) i.v., mivacurium (0.3 mg·kg‐1) i.v. and acetaminophen (10–15 mg·kg‐1) p.r. Following tracheal intubation, patients received either isoflurane (0.8–1.6%) or propofol (120–180 μg·kg‐1min‐1) i.v. with nitrous oxide 70%/oxygen 30% for maintenance of anaesthesia. Vital signs were maintained within 20% of baseline. All patients were extubated in the operating room. PACU nursing staff recorded episodes of vomiting for 4–6 h prior to discharge. A telephone interview the following day was also used for data recovery. Age, sex, and duration of the procedure were not significantly different between the two study groups. Of 19 patients who received propofol, four vomited (21%); in contrast, of the 20 patients who received isoflurane, 11 vomited (55%). This difference is significant (P= 0.048 two‐tailed Fisher's Exact Test). These data suggest that using propofol for anaesthesia can diminish the incidence of

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00293.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY