Pub Date : 1998-02-01DOI: 10.1097/00132586-199802000-00036
L. Arai, S. Stayer, R. Schwartz, A. Dorsey
Intrathecal morphine is an effective technique for providing postoperative analgesia after major surgical procedures in children. Pruritus is a common side effect associated with intrathecal morphine. We report two patients who experienced significant pruritus associated with intrathecal morphine administration and were successfully treated with ondansetron. Ondansetron appears to be a beneficial and safe method of relieving pruritus associated with intrathecal morphine.
{"title":"The use of ondansetron to treat pruritus associated with intrathecal morphine in two paediatric patients.","authors":"L. Arai, S. Stayer, R. Schwartz, A. Dorsey","doi":"10.1097/00132586-199802000-00036","DOIUrl":"https://doi.org/10.1097/00132586-199802000-00036","url":null,"abstract":"Intrathecal morphine is an effective technique for providing postoperative analgesia after major surgical procedures in children. Pruritus is a common side effect associated with intrathecal morphine. We report two patients who experienced significant pruritus associated with intrathecal morphine administration and were successfully treated with ondansetron. Ondansetron appears to be a beneficial and safe method of relieving pruritus associated with intrathecal morphine.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1998-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130513492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1997-12-01DOI: 10.1097/00132586-199712000-00043
I. ISMAIL‐ZADE, R. Vanner
We present a case report of a child who underwent general anaesthesia for elective surgery in whom regurgitation and aspiration of gastric contents were associated with the use of the laryngeal mask airway (LMA). Bronchospasm developed but mechanical ventilation was not required. The possible mechanisms causing regurgitation are discussed.
{"title":"Regurgitation and aspiration of gastric contents in a child during general anaesthesia using the laryngeal mask airway.","authors":"I. ISMAIL‐ZADE, R. Vanner","doi":"10.1097/00132586-199712000-00043","DOIUrl":"https://doi.org/10.1097/00132586-199712000-00043","url":null,"abstract":"We present a case report of a child who underwent general anaesthesia for elective surgery in whom regurgitation and aspiration of gastric contents were associated with the use of the laryngeal mask airway (LMA). Bronchospasm developed but mechanical ventilation was not required. The possible mechanisms causing regurgitation are discussed.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"353 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124469460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1997-12-01DOI: 10.1097/00132586-199712000-00036
I. Selby, J. Rigg, B. Faragher, R. Morgan, T. Watt, P. Morris
A survey was performed to estimate the incidence of the minor sequelae of anaesthesia in children. During an eight-month period 266 children, aged five years and over, were personally interviewed by an anaesthetist following recovery from anaesthesia. At interview the child was questioned to ascertain any morbidity suffered and record was made of the operation performed and the anaesthetic administered. Data were then evaluated, using multivariate analysis, to identify risk factors for the more common sequelae. This study revealed a higher incidence of the minor sequelae of anaesthesia in children than had previously been reported. The three most common sequelae recorded were nausea (48.1%), vomiting (35.0%), and sore throat (31.4%).
{"title":"The incidence of minor sequelae following anaesthesia in children.","authors":"I. Selby, J. Rigg, B. Faragher, R. Morgan, T. Watt, P. Morris","doi":"10.1097/00132586-199712000-00036","DOIUrl":"https://doi.org/10.1097/00132586-199712000-00036","url":null,"abstract":"A survey was performed to estimate the incidence of the minor sequelae of anaesthesia in children. During an eight-month period 266 children, aged five years and over, were personally interviewed by an anaesthetist following recovery from anaesthesia. At interview the child was questioned to ascertain any morbidity suffered and record was made of the operation performed and the anaesthetic administered. Data were then evaluated, using multivariate analysis, to identify risk factors for the more common sequelae. This study revealed a higher incidence of the minor sequelae of anaesthesia in children than had previously been reported. The three most common sequelae recorded were nausea (48.1%), vomiting (35.0%), and sore throat (31.4%).","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"6 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130649779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1997-10-01DOI: 10.1097/00132586-199710000-00027
D. Carapiet, J. Stevens
The case of a 12-year-old girl who suffered a severe intracranial bleed secondary to a large arteriovenous malformation (AVM) is described. Following investigation the appropriate treatment was considered to be embolization of the AVM, under general anaesthesia, using N-butyl cyanoacrylate (NBCA). During the procedure acute desaturation and pulmonary oedema occurred secondary to accidental pulmonary embolization with NBCA. The management of the procedure and subsequent clinical course is reported and available literature reviewed.
{"title":"Pulmonary embolism following embolization of an arteriovenous malformation.","authors":"D. Carapiet, J. Stevens","doi":"10.1097/00132586-199710000-00027","DOIUrl":"https://doi.org/10.1097/00132586-199710000-00027","url":null,"abstract":"The case of a 12-year-old girl who suffered a severe intracranial bleed secondary to a large arteriovenous malformation (AVM) is described. Following investigation the appropriate treatment was considered to be embolization of the AVM, under general anaesthesia, using N-butyl cyanoacrylate (NBCA). During the procedure acute desaturation and pulmonary oedema occurred secondary to accidental pulmonary embolization with NBCA. The management of the procedure and subsequent clinical course is reported and available literature reviewed.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131824111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1997-10-01DOI: 10.1097/00132586-199710000-00035
H. Komatsu, M. Ueki, J. Morita, K. Chujo, K. Ogli
Patients with epilepsy on long term antiepileptic drug (AED) therapy deserve special consideration not only concerning seizure control but also the effect on anaesthetic metabolism and hepatorenal functions. In the present study, we examined the effects of sevoflurane anaesthesia on plasma inorganic fluoride (F-) level and hepatorenal function in patients with and without AED therapy. Twenty-two patients (12 with AEDs = AED group, and ten without AEDs = control group = C group), ASA I, who were free of hepatorenal disease, received approximately 2-3 h sevoflurane anaesthesia. Plasma F- analysis was performed at the stages of: 1) induction of anaesthesia, 2) conclusion of anaesthesia, 3) 15 h after the conclusion of anaesthesia, using an ion-selective electrode calibrated with a standard solution of sodium fluoride. Pre- and postoperative hepatic (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin) and renal (blood urea nitrogen, creatinine) function was tested. There were no significant differences between the two groups in the average age (AED group = 9.4 and control group = 10.1 y.o.), body weight, duration of anesthesia, and MAC hours (2.6 and 2.4). The mean peak F- levels were 15.5 and 13.6 microM, in AED and C groups (not significant), respectively. No patient exhibited F- values greater than 50 microM, the hypothetical nephrotoxic threshold. The patients showed no abnormal values either in hepatic or renal function tests postoperatively. These results suggest approximately 2-3 h sevoflurane anaesthesia to be safe in patients taking AEDs.
{"title":"Clinical characteristics and biotransformation of sevoflurane in paediatric patients during antiepileptic drug therapy.","authors":"H. Komatsu, M. Ueki, J. Morita, K. Chujo, K. Ogli","doi":"10.1097/00132586-199710000-00035","DOIUrl":"https://doi.org/10.1097/00132586-199710000-00035","url":null,"abstract":"Patients with epilepsy on long term antiepileptic drug (AED) therapy deserve special consideration not only concerning seizure control but also the effect on anaesthetic metabolism and hepatorenal functions. In the present study, we examined the effects of sevoflurane anaesthesia on plasma inorganic fluoride (F-) level and hepatorenal function in patients with and without AED therapy. Twenty-two patients (12 with AEDs = AED group, and ten without AEDs = control group = C group), ASA I, who were free of hepatorenal disease, received approximately 2-3 h sevoflurane anaesthesia. Plasma F- analysis was performed at the stages of: 1) induction of anaesthesia, 2) conclusion of anaesthesia, 3) 15 h after the conclusion of anaesthesia, using an ion-selective electrode calibrated with a standard solution of sodium fluoride. Pre- and postoperative hepatic (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin) and renal (blood urea nitrogen, creatinine) function was tested. There were no significant differences between the two groups in the average age (AED group = 9.4 and control group = 10.1 y.o.), body weight, duration of anesthesia, and MAC hours (2.6 and 2.4). The mean peak F- levels were 15.5 and 13.6 microM, in AED and C groups (not significant), respectively. No patient exhibited F- values greater than 50 microM, the hypothetical nephrotoxic threshold. The patients showed no abnormal values either in hepatic or renal function tests postoperatively. These results suggest approximately 2-3 h sevoflurane anaesthesia to be safe in patients taking AEDs.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125001351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1046/J.1460-9592.1999.00321.X
M. Jöhr
{"title":"Is it time to question the routine use of anticholinergic agents in paediatric anaesthesia?","authors":"M. Jöhr","doi":"10.1046/J.1460-9592.1999.00321.X","DOIUrl":"https://doi.org/10.1046/J.1460-9592.1999.00321.X","url":null,"abstract":"","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125042566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1046/J.1460-9592.2000.AB01AD.X
S. D. Playfor, D. Thomas, I. Choonara
{"title":"Recall following paediatric intensive care","authors":"S. D. Playfor, D. Thomas, I. Choonara","doi":"10.1046/J.1460-9592.2000.AB01AD.X","DOIUrl":"https://doi.org/10.1046/J.1460-9592.2000.AB01AD.X","url":null,"abstract":"","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134604651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1046/j.1460-9592.2002.10271_27.x
T. Engelhardt, E. Steel, G. Johnston, D. Veitch
BACKGROUND Pain control for paediatric patients undergoing tonsillectomy remains problematic. Tramadol is reported to be an effective analgesic and to have a side-effect profile similar to morphine, but is currently not licensed for paediatric use in the UK. METHODS We conducted a prospective, double-blind, randomized controlled trial in children who were scheduled for elective tonsillectomy or adenotonsillectomy at the Royal Aberdeen Children Hospital. Following local ethics committee approval and after obtaining a drug exemption certificate from the Medicines Licensing Agency for an unlicensed drug, we recruited 20 patients each into morphine (0.1 mg.kg(-1)), tramadol (1 mg.kg(-1)) and tramadol (2 mg.kg(-1)) groups. These drugs were given as a single injection following induction of anaesthesia. In addition, all patients received diclofenac (1 mg.kg(-1)) rectally. The postoperative pain scores, analgesic requirements, sedation scores, signs of respiratory depression and nausea and vomiting, as well as antiemetic requirements, were noted at 4-h intervals until discharge. RESULTS There were no statistically significant differences in age, weight, type of operation or induction of anaesthesia, 4-h sedation and pain scores and further analgesic requirements. There were no episodes of respiratory depression. Morphine was associated with a significantly higher incidence of vomiting following discharge to the wards (75% versus 40%, P=0.03) compared with both tramadol groups. CONCLUSIONS Tramadol has similar analgesic properties, when compared with morphine. The various pharmaceutical presentations and the availability as a noncontrolled substance may make it a useful addition to paediatric anaesthesia if it becomes licensed for paediatric anaesthesia in the UK.
背景:小儿扁桃体切除术患者的疼痛控制仍然存在问题。据报道，曲马多是一种有效的镇痛药，其副作用与吗啡相似，但目前在英国尚未获准用于儿科。方法:我们在皇家阿伯丁儿童医院进行了一项前瞻性、双盲、随机对照试验，这些儿童计划进行择期扁桃体切除术或腺样扁桃体切除术。经当地伦理委员会批准，在获得药品许可局对未获许可药品的免予药品证明后，我们招募了20名患者，分别分为吗啡(0.1 mg.kg(-1))、曲马多(1 mg.kg(-1))和曲马多(2 mg.kg(-1))组。这些药物在麻醉诱导后单次注射。此外，所有患者均接受双氯芬酸(1 mg.kg(-1))直肠治疗。术后疼痛评分、镇痛要求、镇静评分、呼吸抑制、恶心呕吐症状以及止吐要求每隔4小时记录一次，直至出院。结果两组患者在年龄、体重、手术方式、麻醉诱导、4小时镇静和疼痛评分、进一步镇痛需求等方面均无统计学差异。无呼吸抑制发作。与曲马多组相比，吗啡与出院后呕吐发生率显著升高相关(75% vs 40%， P=0.03)。结论司马多与吗啡具有相似的镇痛作用。如果在英国获得儿科麻醉许可，各种药物介绍和作为非管制物质的可用性可能使其成为儿科麻醉的有用补充。
{"title":"Tramadol for pain relief in children undergoing tonsillectomy: a comparison with morphine.","authors":"T. Engelhardt, E. Steel, G. Johnston, D. Veitch","doi":"10.1046/j.1460-9592.2002.10271_27.x","DOIUrl":"https://doi.org/10.1046/j.1460-9592.2002.10271_27.x","url":null,"abstract":"BACKGROUND\u0000Pain control for paediatric patients undergoing tonsillectomy remains problematic. Tramadol is reported to be an effective analgesic and to have a side-effect profile similar to morphine, but is currently not licensed for paediatric use in the UK.\u0000\u0000\u0000METHODS\u0000We conducted a prospective, double-blind, randomized controlled trial in children who were scheduled for elective tonsillectomy or adenotonsillectomy at the Royal Aberdeen Children Hospital. Following local ethics committee approval and after obtaining a drug exemption certificate from the Medicines Licensing Agency for an unlicensed drug, we recruited 20 patients each into morphine (0.1 mg.kg(-1)), tramadol (1 mg.kg(-1)) and tramadol (2 mg.kg(-1)) groups. These drugs were given as a single injection following induction of anaesthesia. In addition, all patients received diclofenac (1 mg.kg(-1)) rectally. The postoperative pain scores, analgesic requirements, sedation scores, signs of respiratory depression and nausea and vomiting, as well as antiemetic requirements, were noted at 4-h intervals until discharge.\u0000\u0000\u0000RESULTS\u0000There were no statistically significant differences in age, weight, type of operation or induction of anaesthesia, 4-h sedation and pain scores and further analgesic requirements. There were no episodes of respiratory depression. Morphine was associated with a significantly higher incidence of vomiting following discharge to the wards (75% versus 40%, P=0.03) compared with both tramadol groups.\u0000\u0000\u0000CONCLUSIONS\u0000Tramadol has similar analgesic properties, when compared with morphine. The various pharmaceutical presentations and the availability as a noncontrolled substance may make it a useful addition to paediatric anaesthesia if it becomes licensed for paediatric anaesthesia in the UK.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121477975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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