ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-16.x

出版商:Blackwell Science Ltd.    

年代:1996

数据来源: WILEY

摘要:

We attempted to identify specific predictors of preoperative parental anxiety in a population of parents of healthy infants and children undergoing elective, outpatient surgery. We specifically examined the following factors: age of the child, whether or not the child had previous surgery, whether or not the parents» other children had previous surgery, parental gender, highest level of education obtained by the parent, and whether or not there was prior discussion between the parent and anaesthesiologist. In the immediate preoperative period, a questionnaire (State‐Trait Anxiety Inventory) was given to all parents of infants and children presenting for elective, outpatient surgery. Six hundred parents of 417 children, aged two months to 16 years (mean=4.5 years), participated in the study. They included 388 mothers and 212 fathers. Our results indicate that parents are more anxious when their child is less than one year of age and when it is the child's first surgery. When assessed separately by parental gender, both these factors were significant for mothers but not their fathers. We recommend that, although anaesthesiologists generally tailor their preoperative preparation based upon the best needs of their patients and families, they pay special attention to the groups we have identified which are at increased risk for preoperative anxie

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-17.x

出版商:Blackwell Science Ltd.    

年代:1996

数据来源: WILEY

摘要:

In a prospective randomized study the durability of tunnelled and non‐tunnelled central venous catheters was investigated in children with malignant diseases. Twenty children were included in the study but four (two in each group) had to be excluded; three because the entry criteria turned out not to be fulfilled and one because of lack of data. The median duration of the tunnelled catheters was 224 days with a range of 25–846 days which was significantly longer than that of conventional catheters (39.5 days, range 9–228 days). In addition six of eight conventional catheters were accidentally removed whereas all catheters in the tunnelled group had to be removed via a small incision. Three cases of catheter related sepsis, two in the tunnelled group and one in the conventional group, were registered. The corresponding number of infections per catheter days were 1 in 1189 days and 1 in 522 days, respectively. In conclusion cuffed, tunnelled central venous catheters are less prone to displacement than traditional percutaneous central venous catheters when used in children with malignant dis

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-18.x

出版商:Blackwell Science Ltd.    

年代:1996

数据来源: WILEY

摘要:

In a prospective randomized study the durability of tunnelled and non‐tunnelled central venous catheters was investigated in children with malignant diseases. Twenty children were included in the study but four (two in each group) had to be excluded; three because the entry criteria turned out not to be fulfilled and one because of lack of data. The median duration of the tunnelled catheters was 224 days with a range of 25–846 days which was significantly longer than that of conventional catheters (39.5 days, range 9–228 days). In addition six of eight conventional catheters were accidentally removed whereas all catheters in the tunnelled group had to be removed via a small incision. Three cases of catheter related sepsis, two in the tunnelled group and one in the conventional group, were registered. The corresponding number of infections per catheter days were 1 in 1189 days and 1 in 522 days, respectively. In conclusion cuffed, tunnelled central venous catheters are less prone to displacement than traditional percutaneous central venous catheters when used in children with malignant dis

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.2008.02750.x

出版商:Blackwell Science Ltd.    

年代:1996

数据来源: WILEY

摘要:

A randomized prospective study compared three types of needle for caudal analgesia in 623 children. Inadvertent vascular puncture (bloody tap) was more likely if a child weighed more than 15 kg. There were no significant differences in respect to success or complication rate between the needle types (21 g and 23 g standard bevelled intramuscular (IM) needles and 22 g short bevelled «regional block» needle

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-20.x

出版商:Blackwell Science Ltd.    

年代:1996

数据来源: WILEY

摘要:

The rectus sheath block has been used with success for postoperative analgesia in adults. This paper reviews the anatomy of the rectus sheath, and presents our initial experience of using the block to provide intra‐ and postoperative analgesia in children having repair of umbilical and paraumbilical hernia. The rectus sheath block appears to be a useful technique in children, particularly for paediatric day‐case surg

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-24.x

出版商:Blackwell Science Ltd.    

年代:1996

数据来源: WILEY

摘要:

127 children scheduled for elective tonsillectomy or adenotonsillectomy were studied. Anaesthesia was induced with propofol and maintained with a volatile agent. At induction the child received either rectal diclofenac 1 mg·kg−1with or without fentanyl 0.75 μg·kg−1i.v., or intravenous tenoxicam 0.4 mg·kg−1with or without fentanyl 0.75 μg·kg−1i.v. Blood loss was measured peroperatively. Nausea and vomiting scores, sedation scores and pain scores were recorded in the recovery room, at one, two, four and eight h postoperatively and at discharge. There were no significant differences in blood loss between the groups or between nausea and vomiting scores. Pain scores in the tenoxicam without fentanyl group were significantly higher in recovery (P<0.05) than the diclofenac group without fentanyl and both fentanyl groups. This group required supplemental analgesia earlier although this was not significant. The pain scores in the diclofenac with fentanyl group were significantly lower at one h and four h than the group receiving diclofenac alone (P=0.008 and 0.02

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-22.x

出版商:Blackwell Science Ltd.    

年代:1996

数据来源: WILEY

摘要:

Ten paediatric patients (ASA status 1) who had bilateral club foot deformities and underwent bilateral posterior medio‐lateral release within a two week interval (one foot operated each time) were assigned to one of two groups in a double‐blind manner. Group one received caudal bupivicaine (0.25%) 2 mg·kg−1before the surgical incision, followed by caudal normal saline infused at the same volume after the surgical incision. Group two received caudal saline before surgical incision followed by caudal bupivicaine (0.25%) infused 15 min after the surgical incision. No additional analgesic was used before or during the operation. Patients were selected in a manner that allowed each patient to be assigned to either group one or two during the first or second surgical episodes. Anaesthesia was induced with halothane and maintained with nitrous oxide and isoflurane. The anaesthesiologist following the patient for postoperative pain control and analgesic requirement was blinded to the regional technique. Postoperative pain was rated on a paediatric pain scale. Children received a morphine suppository at the appropriate dose related to the body weight for postoperative pain control. There was no significant difference in the cumulative postoperative analgesic requirements within the first 48 h, nor in the time to the first postoperative analgesic administration between the two

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-23.x

出版商:Blackwell Science Ltd.    

年代:1996

数据来源: WILEY

摘要:

Medical histories for 105 consecutive children who underwent selective posterior rhizotomy (SPR) were reviewed to determine the incidence and clinical significance of adverse events related to anaesthesia and surgery. No intraoperative or postoperative events with potential for lasting morbidity, nor life threatening events, were identified. Intraoperatively, the most common adverse events were moderate elevation of body temperature (13/105) and transient dysrhythmias (8/105). The most frequent postoperative complications were fever, marginal oxygen saturation in the absence of supplemental oxygen, and postcatheterization cystitis. Early surgical complications, such as wound infection, cerebrospinal fluid leak, haemorrhage, and bowel or bladder disturbance were absent in this series. Surgical technique and anaesthetic management are described.

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-21.x

出版商:Blackwell Science Ltd.    

年代:1996

数据来源: WILEY

摘要:

Left bronchial intubation was used to achieve selective left lung ventilation in a five‐year‐old child, undergoing thoracotomy for excision of a hydatid cyst of the right lung. Intubation of the left main stem bronchus was easily achieved from the first attempt by a right bevelled tracheal tube. Using a right bevelled tube facilitates left bronchial intubation, since the bevel of the tube faces the right side while its tip lies left to the axis of the trachea. Chest auscultation confirmed selective left lung ventilation. One lung ventilation using 1–2% halothane in 100% oxygen was associated withSpO2that ranged between 95–97%, and endtidalPETCO2ranging between 3.9–4.5 kPa (30–35 mmHg). Following excision of the hydatid cyst, the tube was withdrawn above the carina into the trachea, and two lung ventilation was continued until the end

ISSN:1155-5645    

DOI:10.1046/j.1460-9592.1996.d01-13.x

出版商:Blackwell Science Ltd.    

年代:1996

数据来源: WILEY