ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00390.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.tb00391.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryDespite the low blood‐gas coefficient of desflurane, inhalational induction is delayed by airway complications in paediatric practice. A slow induction technique reduces airway complications in adults. The aim of this study was to examine the use of desflurane for paediatric anaesthesia and to reduce airway complications with a slow induction technique. Sixty children (age range, 1 month to 12 years) were anaesthetized with 3% desflurane, increased by 1% every minute until anaesthesia was adequate for tracheal intubation. Anaesthesia was maintained with oxygen, nitrous oxide, and desflurane delivered by mechanical ventilation. During induction of anaesthesia, the incidence of moderate to severe coughing was 20%, breath‐holding 14%, and laryngospasm 31%. Blood pressure fell significantly (P<0.05) from baseline after induction of anaesthesia and remained at this level during anaesthesia. Heart rate was stable in children less than six years, but increased significantly in older children. There were no significant airway problems during recovery from anaesthesia. Recovery time was rapid: the time to awakening was 10.2 min and to discharge from the recovery room, 29.2 min. Although desflurane is not an ideal anaesthetic agent for inhalational induction in children, it maintains stable anaesthesia and provides rapid smooth recov

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00392.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryThis study was designed to evaluate the hyperglycaemic response to surgery in two groups of children undergoing minor surgical procedures and receiving dextrose‐free solutions during the perioperative period. Twenty‐four unpremedicated children of less than eight years of age were randomly assigned to receive either general anaesthesia using halothane, vecuronium and narcotics (GA group,n= 12) or general anaesthesia (halothane, vecuronium) combined with caudal anaesthesia (RA group,n= 12). In both groups blood glucose and insulin concentrations were measured during inhalational induction (T0), at the end of surgery (T1) and 30, 60, 120 min after surgery (T2, T3, T4). A significant hyperglycaemic response to surgery was observed in the GA group, while no changes in blood glucose were observed in the RA group. The maximal blood glucose value was observed 30 min after completion of surgery. Insulin changes followed closely changes in blood glucose values. This study demonstrates that epidural anaesthesia was effective in reducing the hyperglycaemic response to surgery in children scheduled for minor surgical procedures. The lack of increase in blood glucose values under epidural anaesthesia suggests that blood glucose levels should be monitored during the perioperative period, especially after a prolonged fasting time and when oral intake might be dela

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00393.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryReference values for plasma cholinesterase in adults are available, but data for paediatric patients are scarce. In this study plasma cholinesterase activity and dibucaine number were measured in 111 healthy infants and children two months to 12 years. There were no significant differences in cholinesterase values between the infants and the older children. The cholinesterase activity of the paediatric population was comparable to that of adults. One infant had markedly decreased cholinesterase activity and was presumed to have an atypical variant of the enzyme. Further analysis of this child and the family, identified that this child had most probably the atypical allele (E1aE1a), whereas his two siblings, his mother and maternal uncle were probably heterozygous. The implications of cholinesterase activity in the paediatric population are discussed.

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00394.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryA prospective study of otherwise healthy unpremedicated children scheduled for outpatient surgery was undertaken to determine the relationship between preoperative anxiety and gastric fluid volume and acidity in children. The anxiety level of the child, using a six point anxiety scale, was determined in the preoperative holding area 15–30 min before surgery. After induction of anaesthesia and tracheal intubation, a multi‐port large bore catheter was inserted orally to aspirate gastric contents. Gastric fluid volume was measured and its pH was determined by an Accumet® 915 pH meter. One hundred and fifty patients, between 2 and 10 years of age (mean 5.3 ± 3.0 yrs), weighing 11.2–69.0 kg (mean 22.3 ± 15.4) were studied. Gastric contents could only be aspirated in 101 out of 150 patients. Gastric fluid volume averaged 0.41 ± 0.31 ml·kg−1in these 101 patients. The average pH was 1.54 ± 0.40. Thirty two patients (21%) had gastric fluid volume>0.4 ml·kg−1and pH<2.5. Neither the gastric volume nor the pH correlated with the preoperative anxiety scores. We conclude that in otherwise healthy children undergoing outpatient surgery, preinduction anxiety does not affect gastric volum

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00395.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryTotal intravenous anaesthesia (TIVA) has been performed in 54 paediatric patients undergoing laparoscopic surgery. A loading dose of propofol 2.5 mg·kg−1and fentanyl 2 μg·kg−1were used for induction while a continuous infusion of propofol 9 mg·kg−1·h−1and atracurium 0.5 mg·kg−1·h−1in O2/Air were used for maintenance. Intraoperative cardiorespiratory stability, prompt recovery, painless postoperative period show that TIVA is a valid and safe technique for laparoscopic s

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00396.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryWhen ilioinguinal/iliohypogastric nerve blockade is used to provide postoperative analgesia after paediatric orchidopexy, supplemental analgesia may be required postoperatively. Diclofenac is a nonsteroidal analgesic which produces effective analgesia after tonsillectomy. We examined the effect of combining diclofenac with inguinal field block for post orchidopexy analgesia. Following induction of anaesthesia, group 1 (n= 25) received ilioinguinal block and rectal diclofenac (2 mg·kg−1) and group 2 (n= 25) received ilioinguinal block alone. Objective pain scores were assessed for the first three h postoperatively and the incidence of postoperative rescue analgesia, noted. Pain scores were significantly less in group 1 at 45, 60, 90 and 120 min postop (P<0.05). The postoperative analgesic requirement was significantly lower in the diclofenac group compared to control (P<0.05). A single administration of rectal diclofenac is a simple and effective method of significantly improving analgesia associated with inguinal field block, after paediatric orchidope

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00397.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryWe have used nitric oxide in the treatment of four children admitted to the paediatric intensive care unit with acute, severe respiratory failure. Administration resulted in an improvement in arterial oxygenation range 1.3–18.4 kPa (9.9–140 mmHg): mean 6.7 kPa (51 mmHg) and a reduction in arterial carbon dioxide tension range 0.6–1.2 kPa (4.5–9 mmHg): mean 0.9 kPa (6.8 mmHg). No adverse effects were encountered following administration for a duration of 3–12 days at a dose of 40–64 parts

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00398.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryA three‐and‐a‐half‐year‐old female with the Ellis‐van Creveld syndrome (EVS) underwent a successful anaesthetic for amputation of a digit. EVS is a rare congenital disease involving the skeletal, pulmonary, and cardiac systems. The manifestations of EVS and anaesthetic management of patients with EVS ar

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00399.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY