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At least 19 recordsLinked to original sources

Hypglycaemia in paediatric anaesthesia: The influence of metoclopramide and oral maltose in paediatric surgical patients.

A safe and effective way to prevent the development of hypoglycaemia in young children during general anaesthesia is to give drinks sweetened with maltose 2 hours before operation. Metoclopramide (Maxolon) is injected intramuscularly to hasten absorption. The postoperative blood sugar in the maltose-treated group (28 patients) was 100+/-22-21 mg/ml (5-5+/-1-232 mmol/litre) and significantly higher ( P less than 0-0005) than in the starved group (22 patients).

Anesthesia, General

Coaxial scavenger for paediatric anaesthesia.

A new scavenging device suitable for the Jackson-Rees modification to the Ayre's T-piece is described. This device maintains the essential components of the modification while effectively scavenging the circuit.

Air Pollution

Paediatric anaesthesia: pharmacological considerations.

The young infant differs from the adult in his quantitative responses to many anaesthetic drugs and adjuncts. In the neonate, the larger extracellular fluid volume and blood volume, the smaller muscle mass and fat stores, and presumable greater blood flow to the central organs, not only influence the distribution of drugs to their active site but also secondary redistribution. The neonatal hepatic anzyme systems responsible for the metabolism of drugs are incompletely developed or absent. Glomerular filtration, important for drug excretion, is inefficient by adult standards. The neonate has increased toxicity and sensitivity to a variety of sedative-hypnotics, narcotics, and local anaesthetics. On the other hand, the infant requires more suxamethonium (succinylcholine) and ketamine on a weight basis that does the adult. The response of some infants to non-depolarising muscle relaxants resembles that of the myasthenic patients. The rate of uptake of alveolar levels of inhalation anesthetics is more rapid in infants and children than in adults. In addition, the neonate requires more anaesthetic than the adult for a given surgical stimulus. Biotransformation of inhalation anaesthetics is limited in neonates. Awareness of these pharmacological differences and their probable explanations allows one to provide rational, safer anaesthesia to infants.

Anesthesia

A comparative study of halothane and enflurane in paediatric outpatient anaesthesia.

Two groups of paediatric patients, consisting of 40 patients each, were studied with regard to anaesthesia induction and recovery. Group H was given halothane and Group E received enflurane. The induction time was similar for the two groups. Enflurane had, on average, a shorter recovery time (17 +/- 4 min) than halothane (26 +/- 4min) (P less than 0.05). The mean dose of anaesthetic given, expressed as the product of inspired concentration times minute ventilation, was 2.3 +/- 0.2 1 100% halothane and 2.8 +/- 0.2 1 100% enflurane. If one assumes that the minimum alveolar concentration (MAC) value for enflurane twice that of halothane, group E received a less potent anaesthetic dose. This might explain the similar induction times, and, in part, the shorter recovery time for enflurane in this study. No difference was noted between the two agents with regard to post-operative nausea and vomiting or restlessness.

Adolescent

Caudal anaesthesia in paediatric patients.

We have described our technique of caudal anaesthesia in children. This technique was used for relief of post-operative pain in 120 patients. Relief of pain was complete. Post-operative recovery was quiet and comfortable, with no side effects. The surgeons, the parents and recovery room personnel were satisfied. There were no surgical or anaesthetic complications.

Anesthesia, Caudal

Breath-by-breath halothane monitoring during anaesthesia. A study in children.

The use of a halothane meter in routine paediatric anaesthesia with controlled ventilation is described. The results demonstrate the accuracy achieved in the control of the alveolar halothane concentration. Measurement of the alveolar halothane concentration revealed responses to surgical stimulation otherwise obscured by neuromuscular blockade, and this may indicate insufficient depth of anaesthesia.

Adolescent

A study of waste gas scavenging in operating theatres.

Measurements of atmospheric nitrous oxide concentrations were made in eight hospitals, using 30 anaesthetic machines and locations, during 41 anaesthetic administrations or simulations. All areas were air conditioned, two by laminar flow devices. All anaesthetic machines and ventilators were fitted with commercially available gas collector (scavenger) valves. In all areas except one, venturi suction was used to exhaust gases. Pollution levels during endotracheal anaesthesia did not exceed the recommended 30 ppm. except where leaking anaesthetic machines or nitrous oxide supplies were used. In two instances where paediatric anaesthesia was administered through uncuffed endotracheal tubes nitrous oxide levels were also excessive. Of nine anaesthetics administered through face masks, only in one was the ambient nitrous oxide concentration acceptable. During induction of anaesthesia using nitrous oxide, unacceptable peaks of concentration were encountered. In two air conditioned recovery rooms tested, nitrous oxide concentration was acceptable. The collector valves performed their function satisfactorily, but laminar flow air conditioning was insufficient in itself to maintain acceptably low nitrous oxide concentration without the use of scavenging.

Air Conditioning

Noninvasive evaluation of cardiovascular effects of preoperative sedation in children.

The cardiovascular effects of two premedication regimes used in paediatric anaesthesia were studied. Eleven patients received rectal methohexitone (22 mg - kg) and 11 patients received intramuscular Innovar (0.03 ml - kg). The effect of these drugs on ventricular function was evaluated by measuring the shortening of the left ventricular minor dimension by echocardiography. No significant changes in this dimension, blood pressure, heart rate or respiratory rate were demonstrated with either drug. Both rectal methohexitone and intramuscular Innovar were shown to have minimal cardiovascular effects when used as preoperative sedation in paediatric patients. Echocardiography proved to be a valuable technique for the noninvasive evaluation of drug effects on myocardial contractility in children.

Child