ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1991.tb00001.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1991.tb00002.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1991.tb00003.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The legal and ethical considerations of obtaining consent in children are discussed. It is clear that the ‘emancipated minor’ concept is well recognized in most legal systems throughout the world, with the consequent legal capacity to consent to medical treatment. The outcome of refusal of treatment by the minor is, however, unclear and has never been tested in law. Refusal of treatment by the parent, on the other hand, is in the vast majority of cases not acceptable to the courts and they would therefore accept medical opinion about what is in the best interests of the ch

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1991.tb00004.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

In order to study gas exchange and metabolic rate in anaesthetized children scheduled for corrective cardiac surgery and to find out if chronic hypoxaemia influenced gas exchange and energy expenditure, oxygen consumption (V̇O2) and carbon dioxide elimination (Vdot;co2) were measured and energy expenditure (E) was calculated. Infants and children whose haematocrit (Hct) was less than 44% and arterial oxygen saturation (Sao2) on room‐air was greater than 93% were classified as acyanotic (group AC,n= 11, weight range 3.7 to 20 kg), and those whose Hct was higher than 44% andSao2less than 93% as cyanotic (group C,n= 14, weight range 3.4 to 24.3 kg). The majority of children in both groups weighed less than the 50th percentile for normal children. There was no difference inV̇o2,V̇co2andEbetween the groups. These variables were related to weight according to the following expressions:V̇o2(ml min−1) = 6.1 × kg + 21.6,r= 0.95;V̇co2(ml min−1) = 5.7 × kg + 2.9,r= 0.96, andE(kcal h−1) 1.8 × kg + 5.3;E(J h−1) = 7.6 × kg + 22.3,r= 0.96. Fluid volumes (FV) could be calculated according to the expression:FV(ml h−1) = 3.0 × kg + 8.7;r= 0.96. Oxygen consumption was 15 to 20% higher in anaesthetized infants and children with congenital heart malformations than in anaesthetized infants and children with normal cardiopulmonary function. Accordingly, energy expenditure and fluid requirements were also higher. This difference was most probably due to an undernutrition in children with congenital heart malformations which resulted in a compens

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1991.tb00005.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Forty‐seven children with congenital heart disease received ketamine 3 mg kg−1intramuscularly as a pre‐induction agent. During the 10 min observation period following ketamine administration no adverse cardiovascular or respiratory side‐effects were seen. Arterial oxygen saturation as measured by pulse oximetry remained constant in all patients. In the group of children with cyanotic heart disease, there was a trend towards improvement of oxygen saturation which became significant 10 min after ketamine administration. We conclude that ketamine is a useful pre‐induction agent when used in the appropriate d

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1991.tb00006.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Airway irritability often occurs during induction of anaesthesia with isoflurane and may be accompanied by substantial reductions in oxygen saturation. The aim of this study was to determine the influence of atropine pre‐anaesthetic medication on the induction characteristics of isoflurane. The incidence and severity of airway complications were significantly reduced in children who received atropine, both the oral and intra‐muscular routes being equally effective. However, almost half the children receiving no premedication had saturation levels less than

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1991.tb00007.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Cutaneous reactions and plasma histamine levels were evaluated in 30 adolescents subsequent to the administration of suxamethonium 1.5 mg kg−1or atracurium 0.6 mg kg−1. Plasma histamine levels were measured by the radio‐enzymatic assay using histamineN‐methyl transferase. In the atracurium group, the change in plasma histamine level was significant at the 2 min mark, but was not significant in the suxamethonium group. About 60% of the patients in each group developed a cutaneous reaction. Erythematous cutaneous reactions following atracurium were frequently associated with a mild increase in plasma histamine levels, whereas the rashes induced by suxamethonium in adolescents were not associated with changes in plasma hi

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1991.tb00008.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Caudal epidural anaesthesia was performed in 25 awake or sedated infants, the sensory levels measured and the dose‐response determined (bupivacaine dose [ml kg−1] v. sensory level). The infants were divided into two groups based on body weight, group 1 (1.9–2.6 kg) and group 2 (3.4–7.0 kg). There was a significant difference between the dose‐response when comparing group 1 to group 2 (P<0.01). Smaller infants require a larger volume (ml kg−1) of local anaesthetic to achieve mid‐thoracic sensory levels than larger infants. In small infants, we recommend increasing the volume of local anaesthetic while still limiting the total bupivacaine dose to 3.25 mg kg−1by using 1.6 ml kg−1of bupivacaine 0.20% (3.20 mg kg−1) instead of 1.3 ml kg−1of bupivacaine

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1991.tb00009.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

A transient inability to open the eyes after total intravenous anaesthesia with propofol is described in a 4‐year‐old child. The possible mechanisms of the production of this complication are discus

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1991.tb00010.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY