ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00407.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.tb00408.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This study compares induction and recovery characteristics of desflurane and halothane in children undergoing elective outpatient surgery (hernia repair, circumcision and orchidopexy). Fifty‐six patients one month to 12 years of age were randomly assigned to one of three study groups. In addition to nitrous oxide, group I received desflurane (D) for induction and maintenance; group II received halothane (H) for induction and desflurane for maintenance; and group III received halothane for induction and maintenance. All patients received caudal blocks at the end of surgery. There was no significant difference in induction time (mean ± SD) among the three groups (1.7 ± 0.5, 1.7 ± 0.5 and 1.0 ± 0.5 min for groups I, II and III respectively). Airway complications (coughing, breath holding, and laryngospasm) were significantly higher among the children induced with desflurane than among either of the halothane induction groups. Premedication had no effect on reducing the number of airway complications. Emergence and recovery times (mean ± SD) were significantly shorter among both desflurane maintenance groups (3.6 ± 1.7 and 11 ± 8 min) than among the group maintained on halothane (7.9 ± 3.5 and 29.9 ± 10.6 min respectively). A brief halothane induction did not compromise the fast recovery characteristics of desflurane. There was no difference among the groups in time to discharge home (approx. 3 h). This study confirms the value of desflurane as a maintenance agent in paediatric anaesthesia. In our patients, a brief halothane induction did not compromise the fast recovery characteristics of

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00409.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Rectally administered midazolam has proved to be a reliable and acceptable way of premedicating children. In order to determine the optimal dose 80 children were randomized in a double‐blind manner to receive one of four different dosages of midazolam (0.2–0.3–0.4–0.5 mg·kg−1) in combination with atropine 0.02 mg·kg−1rectally. Observations before and after premedication showed no clinically relevant differences in ventilatory and cardiovascular parameters. Neither did the groups differ as regards acceptance of the mask or awakening from anaesthesia. Regardless of group the level of sedation was increased, but only children receiving 0.4 or 0.5 mg·kg−1of midazolam showed an increase in the level of anxiolysis. For this reason a low dose of midazolam (0.2 mg·kg−1) can be used, except in cases where pronounced anx

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00410.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Guidelines for paediatric practice suggest that the laryngeal mask airway (LMA) is best inserted after a period of inhalational anaesthesia. This study compared the success rate and incidence of complications for LMA placement using two different techniques of general anaesthesia. Sixty ASA I or II patients between the ages of 19 months and 14 years of age were studied. In Group 1, anaesthesia was induced with propofol, 4 mg·kg−1, and placement of the LMA was then attempted. In Group 2, anaesthesia was similarly induced with propofol, but the lungs were then ventilated with halothane in oxygen for placement of the LMA. Although limb movement occurred more often in Group 1 (P<0.001), there were no differences between the groups for other complications, nor for success in placing the LMA. We conclude that in paediatric patients, the LMA may be successfully placed using propofol, 4 mg·kg−1

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00411.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Eleven children undergoing bone marrow harvesting were studied on 15 occasions to assess whether preoperative haemodilution and the acceptance of a transiently low haemoglobin concentration (5 g·dl−1) during anaesthesia, would obviate the need for giving allogenic blood. Before harvesting, 20 (8–28) ml·kg−1of blood (median (range)) was collected in citrate‐phosphate‐dextrose (CPD) bags and replaced isovolaemically with dextran‐60 in Ringer's acetate. Replacement of the harvested volume (26 (17–42) ml·kg−1) was done with the same solution. The bag content was reinfused before awakening; red cells recovered during processing of the bone marrow 2–4 h postoperatively. The preoperative haemoglobin concentration (Hb) was 10.3 (8.7–12.3) g·dl−1and central venous oxygen saturation (Scvo2) 82 (70–94)%. Hb decreased to 5.4 (4.7–8.4) g·dl−1(P<0.01) at the end of harvest, andScvo2to 76 (60–92)% (P<0.05). Retransfusion from the CPD bags increased Hb to 6.8 (5.8–9.5) g·dl−1(P<0.05). After extubation Scvo2decreased to 67 (55–79)% (P<0.05). Reinfusing the harvested red cells increased Hb to 8.6 (6.6–10.5) g·dl−1andScvo2to 74 (59–78)%. Hb one week after the harvest was 11.0 (7.4–12.7) g·dl−1. The authors conclude that the combination of preoperative and intraoperative haemodilution was well tolerated as judged from haemodynamics,Scvo2and pH and allowed large volumes of bone marrow

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00412.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Postoperative haemoglobin oxygen saturation values (Spo2) may be decreased after even minor surgical procedures. Therefore, we evaluated the incidence of postoperative hypoxaemia in children randomized to receive either halothane–nitrous oxide (N2O) or propofol–N2O, during a standardized anaesthetic technique for superficial surgery. After tracheal extubation, all patients received 100% oxygen for at least 3 min and then were transported to the Postanaesthetic Care Unit (PACU) in the left lateral position. TheSpo2values were monitored in the PACU and supplemental oxygen was administered to all patients withSpo2<90%. There were no significant differences in demographic characteristics or in the times to tracheal extubation and transport to the PACU between the two groups. WhileSpo2values decreased in both groups during transport, they did not differ significantly at any time in the PACU. In addition, no significant differences inSpo2values were noted at any point between subgroups of patients who did or did not undergo surgical procedures associated with postoperative pharyngeal bleeding. We conclude that the use of propofol does not decrease the incidence of postoperative hypoxaemia in this patient populat

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00413.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Optimal conditions for pulmonary lobectomy requires the use of a ventilation system which allows the collapse of the ipsilateral lung. In infants and small children, a double lumen tracheal tube cannot be used because an appropriately sized tube is not widely available. We report the successful use of a tracheal tube, along which a Fogarty arterial catheter was passed and inflated in a mainstem bronchus, thus providing adequate ventilation and oxygenation as well as optimal surgical conditions for a left lower lobe lobectomy.

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00414.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The use of inhaled nitric oxide (NO) in a five‐year‐old boy following cardiac surgery for a complex lesion is reported. Pulmonary hypertension causing right ventricular failure and severe hypoxaemia was dramatically reversed by 40 ppm NO added to the inhaled gases. The patient eventually died from the results of left ventricular fail

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00415.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.tb00416.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY