ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00198.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00199.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00200.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThere are many potential problems associated with anaesthesia in patients with lipid storage diseases. This review covers an 8‐year period (1983–1990) during which time 13 patients presented for procedures associated with bone marrow transplantation. The case notes of 12 patients who underwent a total of 48 general anaesthetics were reviewed. Pre‐operative assessment revealed cardiorespiratory disease in six patients. Eighty per cent of the children were anaemic (haemoglobin<95 g1‐1). Anaesthesia was tolerated well although tracheal intubation in two patients with Gaucher's disease was difficult and became progressively more difficult as they became older. Forty‐five per cent of patients with Gaucher's disease were intubated with a tracheal tube smaller than predicted from the age of the child. Few complications were encountered but those which may be anticipated are

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00201.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryFresh gas flow into a circle system can affect the delivered minute ventilation because fresh gas flow augments the flow delivered by the ventilator bellows during inspiration. After establishing a stable ventilatory pattern with 3.0 l·min‐1fresh gas flow into a circle system, changes in peak inflation pressure, minute ventilation and end‐tidal carbon dioxide were measured at 1.5 l·min‐1and 6.0 l·min‐1in 10 toddlers (10–20 kg) and 10 children (30–60 kg). Changes in all variables were observed but these changes were greater in toddlers compared with children (P<0.001). Some toddlers were noted to have as much as a 37% change in ventilatory parameters when fresh gas flow was altered between 1.5 and 6.0 l·min‐1. Whenever changes are made in fresh gas flow, compensatory changes in minute ventilation should be considered to avoid unintended hyperventilation or hypoventilation. This is especially important during anaesth

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00202.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryDiazepam, in combination with pethidine and atropine, has proved to be an effective oral pre‐anaesthetic medication for paediatric outpatient surgery. Triazolam is a benzodiazepine with a short half‐life and rapid oral absorption, and causes amnesia and sedation. The results of a prospective, randomized, double‐blind study substituting triazolam for diazepam in this regimen are described. One hundred and nineteen healthy paediatric outpatients older than 1 year of age were randomized to receive either our routine oral outpatient premedication (pethidine 1.5 mg·kg‐1, diazepam 0.15 mg·kg‐1and atropine 0.02 mg·kg‐1), an oral premedicant where triazolam (0.005 mg·kg‐1) was substituted for diazepam or an oral premedicant containing pethidine and atropine only. Children given triazolam had a more rapid onset of pre‐anaesthetic medication effect (change in state of consciousness) compared with patients in the other two groups (P<0.01). Patients receiving traizolam showed more evidence of sedation within 45 min of receiving the oral premedication (P<0.003). There were no other differences betwe

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00203.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThis study documents the age‐related incidence of vomiting in paediatric patients following strabismus surgery under a postoperative policy of delayed oral alimentation (3‐6 h), minimized motion and the avoidance of anti‐emetic medications. The incidence of vomiting prior to discharge was 4%. The average time from completion of surgery to discharge home was 84 min. The overall incidence of vomiting in the 24 h following surgery was 43%; almost half of this incidence occurred during the car ride home. Children 3 years of age or older were twice as likely to vomit than those younger than 3 years of age. A literature review finds that no drug has been shown by independent investigators to decrease consistently the incidence of vomiting following strabismus surgery. For most drugs, anti‐emetic efficacy parallels the degree of sedation and prolongs recovery; once the sedative effects have abated, the incidence of vomiting approaches that in untreated patients. Our protocol allows for early discharge with the same expected incidence of post‐discharge vomiting as reported for children receiving pharmacologic anti‐emetic

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00204.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryIt is essential, when transplantation is considered, firstly to distinguish between regenerative and non‐regenerative tissue or organs, and secondly to assess the amount of risk created. A framework of ethical guidelines could then be set up. There are still many unanswered questions regarding the legality of organ transplantation in minors and legal guidelines are urgently required in many parts of the worl

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00205.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThe economic and psychological benefits of reducing the in‐patient hospital stay are obvious advantages of day case surgery for children. Careful selection, pre‐operative assessment and preparation of children and their parents for day case surgery are vitally important for success. Staffing levels, equipment and facilities must be clearly defined and costed. The implications for waiting lists and the alternative use of in‐patient beds must be taken into account. New anaesthetic, analgesic and monitoring techniques have made intraoperative care for a wide range of paediatric surgical procedures safe and straightforward. Recovery is rapid, uncomplicated and comfortable for the majority of children. Post‐operative care is simple, allowing early mobilization, oral intake and return home. Follow‐up care at home is important and assists audit of the day surgery service. In certain cases, in‐patient admission may be required and facilities for this should be immediatel

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00206.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryBardet‐Biedl syndrome is a rare syndrome characterized by obesity, mental retardation, polydactyly, retinitis pigmentosa and hypogenitalism. These children frequently require multiple anaesthetics for diagnostic and therapeutic measures. The anaesthetic management of a child with the syndrome is described. Eight cases presenting between 1974 and 1990 at the Royal Children's Hospital in Melbourne are reviewed. The anaesthetic problems associated with this syndrome include obesity with consequent difficulty with venous access, placement of local anaesthetic blocks and induction of anaesthesia due to behavioural activit

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1992.tb00207.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY