ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00248.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.tb00249.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SummaryThe results of a prospective assessment of cardiorespiratory changes related to anaesthesia and laparoscopic Nissen fundoplication are described in 25 children aged 1.2 to 14.3 years, weighing 9.0 to 64.0 kg. Respiratory disease or oesophagitis were present in 68% cases. During balanced inhalational anaesthesia, hypotension or bradycardia occurred prior to peritoneal insufflation in three cases of reverse Trendelenburg position. During surgery, intra‐abdominal pressure was in the 6–10 mmHg range. Transiently, two patients were hypotensive while ten were hypertensive.PETCO2gradually increased but only two patients required increased minute ventilation. One bronchial intubation episode developed. Airway complications were related to isoflurane administration. Postoperatively, transient hypoxia (25% cases) was observed during the first 3 h. Analgesia duration was in the 40–1440 min range. Hospital stay was 5.6 ± 1.5 days (mean ± SD). Laparoscopic paediatric fundoplication is safe when hypovolaemia and postoperative hypoxia are pr

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00250.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.tb00251.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SummaryOne hundred and twenty‐one children were studied in this prospective, randomized double‐blind, placebo‐controlled comparison of the effectiveness of anticholinergic prophylaxis for the prevention of emetic symptoms following strabismus surgery. The children were allocated to three groups, to receive placebo (n= 40), glycopyrrolate (n= 40) or atropine (n= 41). The incidence of intraoperative oculocardiac reflex (OCR) and of postoperative emetic symptoms for 24 h was recorded. The incidence of OCR was 55% in the placebo group compared with 5% and 2% in the glycopyrrolate and atropine groups respectively (P<0.05). Thirty percent (12/40) of patients in the placebo group, 25% (10/40) in the glycopyrrolate group, and 22% (9/41) in the atropine group experienced nausea and/or vomiting (difference not significant). It is concluded that prophylactic administration of anticholinergic agents during strabismus surgery in children despite being effective against the occurrence of the oculocardiac reflex, does not reduce the incidence of emetic sym

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00252.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SummaryCaudal buprenorphine was investigated as a postoperative analgesic in a randomized double blind study in thirty children aged 5–12 years undergoing lower abdominal and lower limb surgery. Comparison was made between two groups of patients, one group receiving plain bupivacaine and the other a combination of plain bupivacaine with buprenorphine. Postoperative analgesia was assessed using a linear analogue scale, and by the response to direct questioning of children using an illustration of sequence of faces. Any untoward side effects and the need for additional analgesics were recorded. The degree and duration of analgesia was far superior in the buprenorphine group and there was a highly significant difference in the requirement of postoperative analgesia between the two groups. There were no major adverse side effects and no motor weakness in either groups, however the incidence of nausea and vomiting was higher in the buprenorphine group. It is concluded that a combination of bupivacaine with buprenorphine administered through the caudal epidural space is a safe and reliable means of providing postoperative pain relief in children for up to 24

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00253.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SummaryThe charts and anaesthetic records of 97 infants less than two years of age who underwent bone marrow transplantation at the University of Minnesota from 1978–1992 were retrospectively reviewed. These infants underwent 564 general anaesthetics. There were 48 perioperative complications, most (39) involving the airway. There were 20 difficult intubations occurring in 13 patients. The causes of the difficult intubations were anatomical abnormalities (12), mucositis (4), pharyngeal oedema (3) and emesis upon induction of anaesthesia (1). Four intraoperative deaths occurred. The deaths were caused by haemorrhage (2), pulmonary embolism (1) and myocardial ischaemia (1). Four patients died within 72 h of surgery; one from cerebral oedema following an intraoperative cardiac arrest, one from fungal septicaemia, one from haemorrhage and one from multiple organ failure following an intracerebral haematoma. Infants undergoing bone marrow transplantation are at high risk for perioperative morbidity and mortality, particularly from complications involving the airway, bleeding or sepsi

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00254.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SummaryIn this study, we compared three gas compositions to determine if the duration of apnoea forSpo2to decrease is proportionate to the oxygen fraction of the gas prior to apnoea. Twenty‐five patients ASA physical status 1–2 aged two months to 12 years were included in the study. Anaesthesia was induced via a mask with 5% sevoflurane and 66% N2O in oxygen. After paralysis with vecuronium (0.12 mg·kg−1, i.v.) the trachea was intubated and anaesthesia was maintained with sevoflurane and N2O in oxygen. When cardiovascular stability was obtained, the patient was randomly set to breathe one of three gas compositions: 1. oxygen (Fio21.0), 2. N2O/O2(Fio20.4), and 3. air/O2(Fio20.4). All three gas compositions included 2–4% of sevoflurane to maintain anaesthesia. After more than eight min of each gas breathing, apnoea was begun by disconnecting the breathing circuit from the tracheal tube. The time from the start of apnoea (Spo2100%) toSpo2of 95% (T95) was measured. T95measured after breathing N2O/O2and air/O2were 34.6 ± 5.7 and 28.8 ± 4.7% of that measured after oxygen breathing (P<0.001vsoxygen breathing,P<0.001vsoxygen and N2O/O2breathing), respectively. Preoxygenation before intubation was validated to delay the haemoglobin desaturation brought about by apnoea. An induction technique using a lowFio2will allow rapid haemoglobin de

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00255.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.tb00257.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SummaryThis double blinded, placebo controlled, randomized, and prospective study investigated the effect of the rapid intravenous administration of ondansetron 0.15 mg·kg−1or metoclopramide 0.25 mg·kg−1on the heart rate, haemoglobin saturation, systolic blood pressure, and diastolic blood pressure in 45 ASA PS I‐II children between two and 16 years of age prior to elective tonsillectomy. The study groups were not significantly different with respect to age, weight, or gender. We were unable to detect a change in heart rate, systolic or diastolic blood pressure, or haemoglobin saturation following the rapid administration of ondansetron or metoclopramide. We conclude intravenous ondansetron or metoclopramide (for the prevention of postoperative vomiting) are not associated with cardiovascular instability when administered rapidly to healthy children prior to elective

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1995.tb00258.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY