Malignant hyperpyrexia and a career in Anaesthesia.
Halsall PJ
[Medline record in process]
Publication Types:
Letter
PMID: 11892670, UI: 21889406
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Anaesthesia 2002 Mar;57(3):307-8
Intrathecal air following spinal anaesthesia.
Hubler M, Litz RJ, von Kummer R, Albrecht DM
[Medline record in process]
Publication Types:
Letter
PMID: 11892660, UI: 21889394
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Anaesthesia 2002 Mar;57(3):306-7
Transient neurological manifestations after epidural analgesia
with ropivacaine.
Al-Nasser B, Negre M, Hubert C
[Medline record in process]
Publication Types:
Letter
PMID: 11892659, UI: 21889391
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Anaesthesia 2002 Mar;57(3):305-6
An audit of the use of low molecular weight heparin and
epidural anaesthesia.
Matthews GA, Davies K
[Medline record in process]
Publication Types:
Letter
PMID: 11892657, UI: 21889383
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Anaesthesia 2002 Mar;57(3):298-9
Anaesthesia for Stiff-Person Syndrome.
Haslam N, Price K
[Medline record in process]
Publication Types:
Letter
PMID: 11892649, UI: 21889368
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Anaesthesia 2002 Feb;57(2):203-4
Use of herbal medicines in ambulatory surgical patients.
Crowe S, Fitzpatrick G, Jamaluddin MF
Publication Types:
Letter
PMID: 11871992, UI: 21861152
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Anaesthesia 2002 Feb;57(2):201-2
Effective labelling is difficult, but safety really does
matter.
Webster CS, Mathew DJ, Merry AF
Publication Types:
Letter
PMID: 11871990, UI: 21861150
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Anaesthesia 2002 Feb;57(2):193-4
Halothane vs. sevoflurane in the difficult airway.
Mills SJ
Publication Types:
Letter
PMID: 11871978, UI: 21861138
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Anaesthesia 2002 Feb;57(2):190-1
A phantom capnograph trace.
Long TM
Publication Types:
Letter
PMID: 11871974, UI: 21861134
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Anaesthesia 2002 Feb;57(2):186-7
Probability of winning the National Lottery.
Fairfield M
Publication Types:
Letter
PMID: 11871967, UI: 21861127
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Anaesthesia 2002 Feb;57(2):180-2
Day surgery and body mass index: results of a national
survey.
Atkins M, White J, Ahmed K
Day Case Unit, Clayton Hospital, Wakefield, UK. micheleatkins@yahoo.co.uk
In March 1992, the Royal College of Surgeons issued Guidelines
for Day Case Surgery. Patients with a body mass index (BMI)
> 30 were deemed unsuitable for operations to be performed
as a day case. Since these guidelines were issued, many
changes have occurred. Two years ago we successfully increased
the BMI limit for patients undergoing general anaesthesia
in our day surgery unit from 30 to 34. The success of this
led us to question the current validity of the Royal College
of Surgeons guidelines. A postal questionnaire was conducted
surveying current practice in day surgical units within
the UK. We achieved a 96% response rate. The results demonstrated
a range of acceptable BMI values, with 85% of units anaesthetising
patients with a BMI > 30. We conclude that many day case
units routinely anaesthetise patients with BMI values >
30. Therefore, the current guidelines, which were issued
9 years ago, are no longer being adhered to nationally.
PMID: 11871956, UI: 21861116
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Anaesthesia 2002 Feb;57(2):169-72
The effect of 10 degrees head-up tilt in the right lateral
position on the systemic blood pressure after subarachnoid
block for Caesarean section.
Loke GP, Chan EH, Sia AT
Department of Anaesthesia (Obstetrics & Gynaecology),
KK Women's and Children's Hospital, 100 Bukit Timah Road,
Singapore 229899.
Forty women presenting for elective Caesarean section under
spinal anaesthesia were randomly assigned to have anaesthesia
induced in the right lateral position either in the horizontal
position or with 10 degrees head-up tilt. Hyperbaric bupivacaine
2 ml 0.5% with 0.1 mg of morphine was injected intrathecally
before the parturients were placed in the supine position
with 15 degrees left lateral tilt. Blood pressure and heart
rate were monitored every minute and the sensory level (loss
of sharp sensation to pinprick) was monitored every 3 min
until clamping of the umbilical cord. Ephedrine 6 mg was
given every minute that the systolic blood pressure decreased
below 90 mmHg. The mean systolic blood pressure during the
first 5 min after induction of spinal anaesthesia was lower
in the control group compared to the tilted group (99 mmHg
vs. 109 mmHg; p = 0.043). The upper limit of block was higher
in the control group compared to the tilted group (p = 0.002).
The use of 10 degrees head-up tilt resulted in a reduced
incidence of hypotension initially and less extensive sensory
block.
Publication Types:
Clinical trial
Randomized controlled trial
PMID: 11871954, UI: 21861114
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Anaesthesia 2002 Feb;57(2):162-8
Measuring the filtration performance of breathing system
filters using sodium chloride particles.
Wilkes AR
Department of Anaesthetics and Intensive Care Medicine,
University of Wales College of Medicine, Heath Park, Cardiff
CF14 4XN. wilkes@cf.ac.uk
The filtration performance of 33 breathing system filters
(nine pleated hydrophobic and 24 electrostatic filters)
was measured using sodium chloride particles. The particles
had a size distribution with a count median diameter of
0.07 microm and a geometric standard deviation not exceeding
1.83. The geometric mean penetration values ranged from
0.002 to 0.67% for the nine pleated hydrophobic filters
and from 0.25 to 35% for the 24 electrostatic filters (p
< 0.0001 for the difference between the two filter types).
The filtration performance obtained when filters are challenged
with either sodium chloride particles or microbes is compared
and discussed.
Publication Types:
Evaluation studies
PMID: 11871953, UI: 21861113
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Anaesthesia 2002 Feb;57(2):133-9
Remifentanil and the tunnelling phase of paediatric ventriculoperitoneal
shunt insertion. A double-blind, randomised, prospective
study.
Chambers N, Lopez T, Thomas J, James MF
Department of Anaesthesia, Red Cross Children's Hospital,
University of Cape Town, Rondebosch, Cape Town, South Africa.
Sixty-two children were randomly allocated to receive,
during inhalational anaesthesia with isoflurane and nitrous
oxide, either 1.0 microg x kg(-1) remifentanil (n = 33)
or saline (n = 29) just before the tunnelling phase of ventriculoperitoneal
shunt insertion, in a double-blind study. The remifentanil
group showed little stress response to tunnelling as indicated
by median (interquartile range [range]) change in heart
rate -5.2 (-11.4 to 9.8 [-19.4 to 30.4])%, mean arterial
pressure -5.0 (-20.8 to 15.5 [-40.9 to 42.9])% or plasma
norepinephrine -13.5 (-38.1 to -2.5 [-77.7 to 81.5])% compared
with the saline group, in which the changes were 20.1 (11.5-36.1
[2.1-83.1])%, 42.7 (27.1-56.8 [3.2-73.5])% and 13.3 (0.8-70.0
[-45.2 to 337.5])%, respectively (p < 0.001 for all comparisons).
These changes were consistent across most different age
categories. The cardiovascular response in the saline group
lasted for 8 (4-15 [0-39]) min. Tracheal extubation occurred
after 3 (2-4 [1-8]) min in the remifentanil group and 3
(2-6 [0-15]) min in the saline group (p = 0.29), with transfer
to the recovery area and discharge to the ward, respectively,
4 (4-5 [1-10]) min and 9 (7-13 [2-32]) min in the remifentanil
group and 7 (4-8 [2-18]) min and 14 (10-19 [7-44]) min in
the saline group (p = 0.06 and 0.01, respectively). Postoperatively
there was some evidence of respiratory depression and increased
oxygen requirements in all age categories, but this was
similar in both groups. Overall, the maximum increase from
baseline in transcutaneous carbon dioxide tension was 41.2
(11.3-66.7 [-2.0 to 141.7])% in the remifentanil group compared
with 30.7 (20.5-55.1 [1.7-159])% in the saline group (p
= 0.8), and the time taken for transcutaneous carbon dioxide
tension to decrease to < 6.0 kPa was 4 (0-13 [0-60])
min compared with 7 (0-13 [0-60]) min, respectively (p =
0.75). There was no difference between the two groups in
postoperative analgesic requirements or in blood loss and
there were no significant side-effects. We conclude that
remifentanil is an appropriate and safe analgesic to provide
balanced anaesthesia to cover the tunnelling phase of paediatric
ventriculoperitoneal shunt insertion.
Publication Types:
Clinical trial
Randomized controlled trial
PMID: 11871950, UI: 21861110
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Anaesthesia 2002 Feb;57(2):128-32
Comparison of times to achieve tracheal intubation with
three techniques using the laryngeal or intubating laryngeal
mask airway.
Pandit JJ, MacLachlan K, Dravid RM, Popat MT
Nuffield Department of Anaesthetics, John Radcliffe Hospital,
Oxford OX 9 DU, UK.
We compared the times to intubate the trachea using three
techniques in 60 healthy patients with normal airways: (i)
fibreoptic intubation with a 6.0-mm reinforced tracheal
tube through a standard laryngeal mask airway (laryngeal
mask-fibreoptic group); (ii) fibreoptic intubation with
a dedicated 7.0-mm silicone tracheal tube through the intubating
laryngeal mask airway (intubating laryngeal mask-fibreoptic
group); (iii) blind intubation with the dedicated 7.0-mm
silicone tracheal tube through the intubating laryngeal
mask airway (intubating laryngeal mask-blind group). Mean
(SD) total intubation times were significantly shorter in
the intubating laryngeal mask-blind group (49 (20) s) than
in either of the other two groups (intubating laryngeal
mask-fibreoptic 74 (21) s; laryngeal mask-fibreoptic group
75 (36) s; p < 0.001). However, intubation at the first
attempt was less successful with the intubating laryngeal
mask-blind technique (15/20 (75%)) than in the other two
groups (intubating laryngeal mask-fibreoptic 19/20 (95%)
and laryngeal mask-fibreoptic 16/20 (80%)) although these
differences were not statistically significant. We conclude
that in this patient group, all three techniques yield acceptable
results. If there is a choice of techniques available, the
intubating laryngeal mask-blind technique would result in
the shortest intubation time.
Publication Types:
Clinical trial
Randomized controlled trial
PMID: 11871949, UI: 21861109
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Br J Anaesth 2001 Oct;87(4):649-50
Perioperative bradycardia.
Wildsmith J A
Publication Types:
Letter
PMID: 11878744, UI: 21867532
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Br J Anaesth 2001 Oct;87(4):641-4
Blood pressure manipulation during awake carotid surgery
to reverse neurological deficit after carotid cross-clamping.
Stoneham M D, Warner O
Nuffield Department of Anaesthetics, Oxford Radcliffe NHS
Hospital, Headington, UK.
We describe the management of three patients undergoing
awake carotid surgery who developed signs of cerebral ischaemia
after carotid cross-clamping. Drug treatment to increase
arterial blood pressure above baseline reversed the neurological
deficit and an internal carotid artery shunt was not needed.
Shunt insertion is less frequent with regional rather than
general anaesthesia, and blood pressure control can reduce
this even more. Coincidentally, one of the patients, who
gave a history of angina of effort after walking 100 m,
complained of chest pain after cross-clamp release. This
was treated successfully with sublingual nitroglycerin before
ST segment changes became apparent on the ECG. These reports
suggest that regional anaesthesia for carotid surgery allows
potential complications to be identified earlier than under
general anaesthesia using reports from the patient, so that
treatment may be modified to prevent morbidity and even
mortality.
PMID: 11878740, UI: 21867528
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Br J Anaesth 2001 Oct;87(4):631-3
Evaluation of the Greenbaum sub-Tenon's block.
Kumar C M, Dodds C
James Cook University Hospital, Middlesbrough, UK.
A prospective, randomized blind study was conducted in
40 patients undergoing phacoemulsification and posterior
chamber intraocular lens implantation. They received anaesthetic
infiltration of 2% lidocaine with 1:200,000 epinephrine
and hyaluronidase 150 U ml(-1) in a volume of 2, 3, 4 or
5 ml into the sub-Tenon's fascial space through a Greenbaum
cannula after a conjunctival incision. Reduction of ocular
movements, anaesthesia, pain on injection and any incidental
complications were recorded. Akinesia and anaesthesia occurred
within 5 min with 4 and 5 ml of local anaesthetic, and no
supplementary injections were required. There were marked
reductions in the frequency of forced eyelid movements with
these volumes. Chemosis and conjunctival haemorrhage were
noted in the majority of patients but caused no intraoperative
problems. Approximately 10-15% of patients reported slight
discomfort at the time of injection. Four to 5 ml of 2%
lidocaine with 1:200,000 epinephrine and 150 U ml(-1) of
hyaluronidase is the optimum volume to achieve adequate
akinesia, anaesthesia and reduction of lid movements during
the Greenbaum sub-Tenon's block.
Publication Types:
Clinical trial
Randomized controlled trial
PMID: 11878736, UI: 21867524
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Br J Anaesth 2001 Oct;87(4):629-31
Randomized prospective double-blind placebo-controlled
trial of effect of intravenous ondansetron on intraocular
pressure during ophthalmic surgery.
Robin N M, Mostafa S M
Department of Anaesthesia, Royal Liverpool University Hospital,
UK.
The effect of i.v. ondansetron, before induction of anaesthesia,
on intraocular pressure (IOP) in patients undergoing cataract
surgery was investigated. Forty patients (two groups of
20) received either ondansetron 4 mg (treatment group) or
0.9% saline (placebo group) in a double-blind controlled
manner. There were no significant differences in IOP between
the groups. Ondansetron had no significant effect on IOP
during the study period.
Publication Types:
Clinical trial
Randomized controlled trial
PMID: 11878735, UI: 21867523
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Br J Anaesth 2001 Oct;87(4):608-24
Minimizing perioperative adverse events in the elderly.
Jin F, Chung F
Department of Anaesthesia, University of Toronto, Toronto
Western Hospital, Ontario, Canada.
Elderly patients still have the highest postoperative mortality
and morbidity rate in the adult surgical population. Preoperative
clinical assessment to detect patients at high risk of postoperative
events, and specific intraoperative and postoperative anaesthesia
management are important to minimize postoperative adverse
events in the elderly.
Publication Types:
Review
Review, academic
PMID: 11878732, UI: 21867520
Eur J Pharmacol 2002 Feb 22;437(3):165-171
Selective mitochondrial K(ATP) channel activation results
in antiarrhythmic effect during experimental myocardial
ischemia/reperfusion in anesthetized rabbits.
Das B, Sarkar C, Karanth KS
Department of Pharmacology, Kasturba Medical College, Manipal,
Karnataka, 576119, India
[Record supplied by publisher]
We investigated the effects of administration of non-hypotensive
doses of ATP-sensitive K(+) channel (K(ATP)) openers (nicorandil
and aprikalim), and a specific mitochondrial K(ATP) channel
blocker (5-hydroxydecanoate) prior to and during coronary
occlusion as well as prior to and during post-ischemic reperfusion
on survival rate, ischemia/reperfusion-induced arrhythmias
and myocardial infarct size in anesthetized albino rabbits.
Arrhythmias were induced by reperfusion following a 20 min
ligation of the left main coronary artery with a releaseable
silk ligature. Early intervention by intravenous infusion
of nicorandil (100 &mgr;g/kg bolus+10 &mgr;g/kg/min) or
aprikalim (10 &mgr;g/kg bolus+0.1 &mgr;g/kg/min) just before
and during ischemia increased survival rate (86% and 75%
vs. 55% in the control group), significantly decreased the
incidence and severity of life-threatening arrhythmias and
myocardial infarct size. The antiarrhythmic and cardioprotective
effects of both nicorandil and aprikalim were abolished
by pretreating the rabbits with 5-hydroxydecanoate (5 mg/kg,
i.v. bolus). In conclusion, intervention by intravenous
administration of nicorandil and aprikalim (through the
selective activation of mitochondrial K(ATP) channels) increased
survival rate and exhibited antiarrhythmic and cardioprotective
effects during coronary occlusion and reperfusion in anesthetized
rabbits when administered prior to and during coronary occlusion.
PMID: 11890905
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JAMA 2002 Mar 13;287(10):1327-8
Books, journals, new media: tarnished idol: william Thomas
green morton and the introduction of surgical anesthesia:
a chronicle of the ether controversy.
Torpy JM
JAMA, Chicago, Ill.
[Medline record in process]
PMID: 11886328, UI: 21884304
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Paediatr Anaesth 2002 Jan;12(1):88-9
Rapid sequence induction for penetrating head injury from
a chopstick in a paediatric patient.
Suzuki H, Saitoh K, Inoue S, Hirabayashi Y, Seo N
Publication Types:
Letter
PMID: 11849589, UI: 21839893
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Paediatr Anaesth 2002 Jan;12(1):65-8
Motion sickness and postoperative vomiting in children.
Busoni P, Sarti A, Crescioli M, Agostino MR, Sestini G,
Banti S
BACKGROUND: Motion sickness is considered an important
risk factor for postoperative nausea and vomiting in children.
The aim of this study was to verify the impact of motion
sickness on the incidence of vomiting after routine surgery
in children, and to compare the incidence of vomiting, after
combined regional/general anaesthesia, using either halothane
or sevoflurane. METHODS: We prospectively studied 420 children
(369 males and 51 females) who received general anaesthesia
and inguinal field block for common paediatric surgery.
The children were randomly allocated into one of two groups
(halothane or sevoflurane). In the 200 children in the first
group (H), general anaesthesia was induced and maintained
with halothane, whereas in the 220 children in the second
group (S), anaesthesia was induced and maintained with sevoflurane.
RESULTS: There were 79 children with a prior history of
motion sickness (MS+) and 341 without such a history (MS-).
In the MS+ population, the incidence of vomiting was similar
in both H and S groups, being around 33%. However, repeated
episodes of vomiting in MS+ children were more frequent
when halothane was used. In the MS- group, the incidence
of vomiting was significantly greater in the H group (19%)
than in the S group (8%). CONCLUSIONS: In the postoperative
period, we found that MS+ children vomit more than MS- children,
regardless of the inhalation anaesthetic used. However,
MS- children displayed a higher incidence of vomiting when
halothane was used rather than sevoflurane.
Publication Types:
Clinical trial
Randomized controlled trial
PMID: 11849578, UI: 21839882
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Paediatr Anaesth 2002 Jan;12(1):53-8
The efficacy of caudal ropivacaine 1, 2 and 3 mg x l(-1)
for postoperative analgesia in children.
Bosenberg A, Thomas J, Lopez T, Lybeck A, Huizar K, Larsson
LE
Department of Anaesthesia, University of Natal, Durban,
South Africa. bosie@nu.ac.za
BACKGROUND: The aim of this double blind, randomized, comparative
study was to assess the analgesic efficacy and incidence
of motor block after caudal block using three different
concentrations of ropivacaine, 1, 2 and 3 mg x l(-1), in
children 4-12-year-old. METHODS: One hundred and ten children
ASA I-II, scheduled for inguinal surgery, were included
in the study. After induction of a standardized general
anaesthetic technique, all patients received 1 ml x kg(-1)
of the ropivacaine solution for a caudal block and were
assessed for 8 h after the injection. RESULTS: The ropivacaine
was well tolerated in all patients. Median time to treatment
with analgesics was 3.3, 4.5 and 4.2 h in the 1, 2 and 3
mg x ml(-1) groups, respectively. During the first 4 h,
the pain scores for both a 6-graded faces scale and a 4-graded
observer scale were higher in the 1 mg x ml(-1) group than
the 3 mg x ml(-1) group. The median sensory block reached
T12 in all groups 1 h after the caudal block. Thereafter,
the speed of regression was correlated with the ropivacaine
concentration. In the patients with a sensory block from
T12 and above, the median time to treatment with analgesics
was longer than in the children with a sensory block below
T12. The incidence of motor block was 28% in the 3 mg x
ml(-1) group in comparison with 0 and 13% in the 1 and 2
mg x ml(-1) groups. CONCLUSIONS: It was concluded that 1
ml x kg(-1) of ropivacaine 2 mg x ml(-1) for caudal block
provided satisfactory postoperative pain relief after inguinal
surgery in 4-12-year-old children. Ropivacaine 1 mg x ml(-1)
showed less efficacy while the use of ropivacaine 3 mg x
ml(-1) was associated with a higher incidence of motor block
with minimal improvement in postoperative pain relief.
Publication Types:
Clinical trial
Multicenter study
Randomized controlled trial
PMID: 11849576, UI: 21839880
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Paediatr Anaesth 2002 Jan;12(1):48-52
Noninvasive intraoperative monitoring of carbon dioxide
in children: endtidal versus transcutaneous techniques.
Nosovitch MA, Johnson JO, Tobias JD
Departments of Child Health and Anesthesiology, The University
of Missouri, Columbia, MO 65212, USA.
BACKGROUND: The current study prospectively compares the
accuracy of the intraoperative use of transcutaneous (Tc)
and endtidal (PE) CO2 monitoring during surgical procedures
in 30 paediatric patients, ranging in age from 6 months
to 15 years (6.15 +/- 4.35 years) and in weight from 4.7
to 73 kg (24.9 +/- 18.2 kg). METHODS: Following calibration
and an equilibration time for the TcCO2 monitor, arterial
blood gas samples were obtained as clinically indicated.
A total of 64 sample sets (PaCO2, PECO2 and TcCO2) were
obtained from the 30 patients. RESULTS: The PECO2 to PaCO2
difference was 0.6-0.9 kPa (4.4 +/- 7.1 mmHg) while the
TcCO2 to PaCO2 difference was 0.36-0.38 kPa (2.8 +/- 2.9
mmHg) (P=NS). The difference between the PaCO2 and PECO2
was 0.4 kPa (3 mmHg) or less in 37 of 64 sample sets while
the difference between the PaCO2 and TcCO2 was 0.4 kPa (3
mmHg) or less in 49 of 64 sample sets (P=0.038). Linear
regression analysis of PECO2 vs. PaCO2 revealed a slope
of 0.434, r=0.8761, r2=0.7676. Linear regression analysis
of TcCO2 vs. PaCO2 revealed a slope of 0.914, r=0.9472,
r2=0.8972. CONCLUSIONS: Although in most circumstances,
both noninvasive monitors of PCO2 provided a clinically
acceptable estimate of PaCO2, TCCO2 provided a slightly
more accurate estimate of PaCO2 during intraoperative anaesthetic
care in children.
PMID: 11849575, UI: 21839879
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Paediatr Anaesth 2002 Jan;12(1):43-7
The use of the cuffed oropharyngeal airway in paediatric
patients.
Bussolin L, Busoni P
Department of Anaesthesiology and Intensive Care, Meyer
Children Hospital, Florence, Italy. riaped@ao-meyer.toscana.it
BACKGROUND: The cuffed oropharyngeal airway (COPA) is a
device which has already been demonstrated to be suitable
for anaesthetized adult patients undergoing either spontaneous
or mechanical ventilation. There are few reports on the
use of the COPA in children. In this study, the authors
assessed the COPA in paediatric patients undergoing minor
surgery. METHODS: The same anaesthesiologist inserted the
COPA in 40 consecutive paediatric patients, ASA I and II,
aged 1.8-15.3 years. (7.4 +/- 3.9), after induction of anaesthesia
with N2O/O2/sevoflurane. COPA size was chosen by measuring
the distal tip of the device at the angle of the jaw with
the COPA perpendicular to the patient's bed. The proper
positioning of the COPA was assessed by observing thoracoabdominal
movements, regular capnograph trace, the reservoir bag movements
and SpO2 > 94% with a fraction of inspired oxygen of
0.5. Anaesthesia was maintained with 1 MAC halothane, sevoflurane,
or isoflurane in N2O/O2 (50%) and the patients were spontaneously
breathing. The stability of the COPA following changes in
head, neck and body position was tested. We recorded the
duration time for COPA insertion, the side-effects of placement
of the COPA and during the intraoperative period, the number
of attempts, the type of manipulation in order to provide
an effective airway and postoperative symptoms, such as
the presence of blood on the device, sore throat, neckache,
jaw pain and PONV. RESULTS: Successful COPA insertion at
the first attempt was 90% and at the second attempt in the
remaining 10%. The most frequent airway manipulations were
head tilt in 27.5% (obtained by a pillow under shoulders)
and chin lift in 5%. No complications both at COPA placement
nor during the intraoperative period were observed. On the
basis of weight and age, the COPA size was no. 8 in 50%,
no. 9 in 30%, no. 10 in 12.5%, and no. 11 in 7.5%. The COPA
demonstrated stability after changes in head, neck and body
position. Postoperative complications were the presence
of blood stains in one case and PONV in six cases (15%).
CONCLUSIONS: The COPA is an extratracheal airway device
suitable in paediatric patients undergoing general anaesthesia
with spontaneous ventilation for minor surgery and other
painful procedures. This study shows that for paediatric
patients: (i) complications seem to be rare; (ii) the COPA
allows hands free anaesthesia; (iii) specific indication
for the COPA could be obese patients with a small mouth;
and (iv) COPA sizing can be easily established by the weight
or age of the patients.
PMID: 11849574, UI: 21839878
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Paediatr Anaesth 2002 Jan;12(1):36-42
A survey of practice of tracheal intubation without muscle
relaxant in paediatric patients.
Simon L, Boucebci KJ, Orliaguet G, Aubineau JV, Devys
JM, Dubousset AM
Hopital Saint Vincent de Paul, Assistance Publique-Hopitaux
de Paris, Paris, France.
BACKGROUND: Because of the renewed interest in intubation
in children without relaxants, over a period of 1 month,
the anaesthesiologists of five paediatric universitary teaching
hospitals were asked to complete a questionnaire each time
they performed a tracheal intubation without muscle relaxant.
METHODS: Intubating conditions were assessed with five items.
Each item was graded on a four-point scale. Intubating conditions
were judged acceptable when all items scored 2 or less.
Episodes of oxygen desaturation and failed intubations were
noted. Data are expressed as mean +/- SD (extremes). RESULTS:
Five hundred and two questionnaires were completed during
the study period. Children were aged 61 +/- 50 (1-180) months
old. Induction of anaesthesia was performed with sevoflurane
for 62.6% of the children (endtidal concentration 5.9 +/-
1.5%) and propofol for 28.9% (dose 5.8 +/- 4.2 mg x kg(-1).
Opioids were associated with these hypnotics in 53.2% of
the children. Tracheal intubation was successful in 87.1%
of the children. Sevoflurane produced better intubating
conditions than propofol. Sevoflurane requirements for tracheal
intubation may be higher in infants aged less than 6 months
old than in older children. A severe decrease in SpO2 (<
or = 90%) was observed in 15.9% of the infants aged less
than 1 year old and in 1.7% of the children, respectively
(P < 0.0001). CONCLUSIONS: Sevoflurane is the most commonly
used agent for tracheal intubation without relaxants with
higher doses being required in infants aged less than 6
months. Propofol, even with opioids, was not so successful.
TUTTO
IL MATERIALE CONTENUTO IN QUESTO SITO E' STATO REPERITO IN RETE. GLI AUTORI
NON SI ASSUMONO RESPONSABILITA' PER
DANNI A TERZI DERIVATI DA USO IMPROPRIO O ILLEGALE DELLE INFORMAZIONI
RIPORTATE O DA ERRORI RELATIVI AL LORO CONTENUTO.
