ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00130.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00131.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryThe effects of increasing concentrations of halothane and isoflurane were studied in two groups of twenty children aged from 2.9 to 9.8 years using the technique of water filled venous occlusion plethysmography. Halothane significantly increased hand blood flow and reduced vascular resistance only at a concentration of 0.5 MAC. However, isoflurane caused significant dose related increases in hand blood flow and reductions in hand vascular resistance at 0.5, 1.0 and 1.5 MAC. These findings suggest that in children isoflurane has a more potent vasodilator effect on the skin circulation than halothane.

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00132.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryNinety‐seven consecutive children (5‐16 years of age), who underwent a major orthopaedic operation received patient controlled analgesia (PCA) as their main therapy for postoperative pain. A Pharmacia DeltecTMpump was used with a bolus dose of 25 μg·kg−1of morphine, a lock‐out period of 8 min, and a maximally delivered dose of 0.1 mg·kg−1in an hour. Two‐thirds of the patients were allocated to receive a concomitant non‐steroidal anti‐inflammatory drug (NSAID), either ibuprofen 40 mg·kg−1or diclofenac 2 mg·kg−1daily. Individual morphine requirement varied greatly (range 0.1‐1.6 mg·kg−1in a day) and could not be predicted preoperatively. It was 29% less in patients receiving a NSAID (0.53 ± 0.35 (SD)vs0.75 ± 0.28 mg·kg−1during the first postoperative day,P= 0.002). Patient's age did not influence morphine requirement, but patients with nausea took 23% less morphine than other patients (P= 0.023). Postoperative nausea was more frequent in patients having a NSAID (52vs31%,P= 0.027). The principle of PCA made it possible to cover even a wide individual range of postoperative opioid requireme

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00133.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryWe report the results of a postal survey of the management of full term babies with pyloric stenosis by specialist paediatric anaesthetists. The conclusions from the survey are that the most likely anaesthetic techniques used are: rehydration and at least partial correction of electrolyte and acid‐base abnormalities before surgery; aspiration of stomach contents before induction of anaesthesia; a rapid sequence induction; extubation of the trachea with the baby awake and on its side; and infiltration of the wound at the end of surgery with local anaestheti

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00134.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryThe actual depth from the skin to the paravertebral space (S‐PVS depth) was determined in twenty paediatric ASA 1 patients (age range: 1‐175 months, weight range: 3.8‐61.0 kg) receiving a thoracic paravertebral block for renal surgery or cholecystectomy. The S‐PVS depth correlated well to patient weight (r= 0.94) and the S‐PVS depth can be predicted by the following equation: S‐PVS depth (mm) = 21.2 + 0.53 × (weight in kg). Our previously reported equation for the prediction of the S‐PVS depth, derived from computed tomography scans, was found to significantly (P= 0.0023) differ from the regression line generated in the present study and will underestimate the S‐PVS depth by approximately 2.5‐3.0 mm compared to the present results. The reader is, thus, recommended to use the new equation for a more accurate prediction of the S‐PVS depth when performing a thoracic paravertebral

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00135.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryWe have measured the times to early recovery in forty children aged 3‐14 years in whom anaesthesia was induced by intravenous propofol, methohexitone, thiopentone or inhalation of enflurane. Maintenance anaesthesia consisted of inhalation of nitrous oxide, oxygen and enflurane via a face mask. Early recovery, assessed by the Steward recovery score, was significantly faster after propofol, methohexitone or inhalation of enflurane compared with thiopentone (P<0.01). There were no significant differences in recovery times between propofol, methohexitone or enflurane. We conclude that the use of propofol to induce anaesthesia does not hasten recovery in children undergoing short day‐case procedures compared with methohexitone or inhalation of enflur

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00136.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryThree hundred and thirteen paediatric day case patients were prospectively audited to assess postoperative pain, nausea and vomiting using data sheets completed by nursing staff, anaesthetists and parents. The incidence of nausea and vomiting was 7.3% and was commoner in older children and those who had received opioids. Forty per cent of patients had some degree of postoperative pain; 17% of these patients were scored as having severe pain. Of children who had pain on returning home (31.4%), 85% of these required paracetamol. Fifteen per cent of children had a disturbed night due to pain and/or vomiting after their operation and 28.5% of children had pain on the following day. Boys undergoing circumcision were responsible for a disproportionately high percentage of the severe pain scores. Audit has helped to highlight deficiencies in the service provided and has led staff to try and improve their methods of analgesia.

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00137.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryIn a newborn with Pierre‐Robin syndrome, repeated attempts using standard direct laryngoscopy failed to visualize the glottis or even the tip of the epiglottis. In contrast, a clear view of the glottis was seen when the Bullard fibreoptic paediatric laryngoscope was used. Tracheal intubation was facilitated by ‘rail‐roading’ the tube over a bougie which was threaded via the suction channel of the laryngoscope into the trachea. The report suggests that the Bullard fibreoptic laryngoscope can succeed to visualize the glottis in the newborn with Pierre‐Robin syndrome, whenever the glottis cannot be brought within line‐of‐sight by standard

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00138.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryIn this paper we describe the perioperative management of a premature infant who underwent excision of a giant sacrococcygeal teratoma, a newborn infant who had a partial hepatectomy for a haemangioendothelioma of the liver and an 18‐month‐old infant who had repair of abdominal aortic, renal and iliac arterial aneurysms. In each case a rapid infusion device was used to deliver warm, washed and ventilated blood to replace massive intraoperative blood loss. Although the blood loss in each operation was in excess of twice the total blood volume of the patient, losses were replaced effectively with the rapid infusion device without any significant hypovolaemic episodes. Successful management of newborn babies and infants undergoing surgery with large and potentially hazardous blood loss can be provided using the rapid infusion device. Paediatric anaesthesiologists should strongly consider using this technology when caring for a baby or infant during surgery where massive haemorrhage may oc

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00139.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY