ABSTRACT
Children, similar to adults, are required to fast before general anesthesia in order to reduce the volume and acidity of stomach contents. It is thought that NPO regulations reduce the risk of regurgitation and aspiration of gastric contents during surgery. Recent developments have encouraged a shift from the standard 'nil by mouth from midnight' fasting policy to more relaxed regimens. Preoperative NPO status for each patient must be regulated according to his/her age and timing of the surgery, the night before the operation [2 hours for clear fluids and 4-6 hours for solid foods and milk before the surgery, considering his/her age]
ABSTRACT
To compare two different doses of propofol for laryngeal mask airway [LMA] insertion in children undergoing out-patient surgeries. Insertion of LMA just after anesthesia induction is facilitated using propofol. However, the optimal dose of this drug not determined yet as heavy doses may lead to severe complications, whereas lower doses may not be quite as effective. In a double-blind randomized clinical trial, 120 children undergoing out-patient surgeries were recruited to receive intravenous propofol at a dose of either 2.5 mg/kg [group 1] or 3.5 mg/kg [group 2] for induction. Intravenous midazolam [0.03 mg/kg] and fentanyl [1 microg/kg] were used as pre-medication in all patients and anesthesia induction was initiated using lidocaine [1 mg/kg] prior to propofol administration. Hemodynamic changes, probable complications, quality of the established airway and number of attempts for LMA insertion were compared between two groups. There were no differences in systolic and diastolic blood pressure, heart rate, peripheral oxygen saturation and intraoperative complications between the groups [P>0.05]. LMA insertion was successful at the first attempt in 55 [93.2%] and 54 [91.5%] cases in group 1 and group 2, respectively [P>0.05]. The efficiency of the established airways was adequate in all the patients of both groups. It seems that propofol doses of 2.5 and 3.5 mg/kg are equally effective for LMA insertion following intravenous midazolam, fentanyl, and lidocaine
Subject(s)
Humans , Female , Male , Propofol , Child , Propofol/administration & dosage , Intubation, IntratrachealABSTRACT
A well-functioning caudal block is an excellent adjunct to general anesthesia, but misplaced injection results in poor analgesia as well as possibility of serious morbidity. Therefore, the purpose of this study was to evaluate the effectiveness of leg traction on success rate of caudal block in lateral position in children. Two hundred children, age 2 months to 6 years, ASA I and II, who underwent lower abdominal surgeries were randomized in prospective controlled clinical trial study in two groups. After induction of General anesthesia, the caudal block was performed in the lateral position with upper leg traction [L-T-] or with the standard position [S-P] [leg flexed 90°]. Hemodynamicchanges, movement of lower extremity in response to surgical stimulus were evaluated. There was no significant difference in caudal block's success rate between two groups at first attempt [P=0.25]. In group [S-P] the procedure was successful in 60% of cases at first attempt, 25% at second,10% at third attempt and 5% failure of caudal block, whereas in the first group it was 75%, 20%, 1% and 4% of cases respectively. There were no significant differences in heart rate and blood pressure changes between two groups [P>0.05]. The success rate of pediatric caudal block in upper leg traction did not differ from that of the standard position
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Anesthesia, Caudal , Analgesia/methods , LegABSTRACT
Nasal ala pressure sores are among complications of nasogastric tube in Pediatric Intensive Care Unit [PICU]. The severity of the injury is usually minor and easily ignored. However, the complication could be easily avoided. This is a case of nasal ala sore after the placement of nasal enteral tube in a pediatric intensive care unit in our center. A 5-month-old female with pulmonary hypertension secondary to bronchiectasis with nasal ala pressure sore were reported. She was hospitalized in pediatric intensive care unit at Tabriz Children Hospital in 2010.After 53 days of PICU hospitaliza-tion she had nasal ala sore. Conclusion: We know that nasal ala pressure sores could easily be avoided when preventive procedures were performed during nasogastric tube insertion
ABSTRACT
The induction dose of propofol is higher in younger children [2.9 mg/kg for infants younger than 2 years] than in older children [2.2 mg/kg for children 6-12 years of age]. A modest reduction in systolic blood pressure often accompanies bolus administration. The major concern with propofol is the potential for propofol infusion syndrome [lactic acidosis, rhabdomyolysis, cardiac and renal failure], which is generally associated with high-dose infusion for an extended period. We report a 38-days-old male infant underwent emergency bilateral inguinal hernia repair who accidentally received a five-fold dose of propofol for induction of general anesthesia
ABSTRACT
Airway management during induction of anesthesia is difficult in some metabolic disorders like mucopolysaccharidosis [MPS]. In this article we report an 11 years old child with Hurler-Scheie syndrome how was admitted to operating room for thracheostomy under general anesthesia. Mask ventilation was difficult and endotracheal intubation was impossible and anesthesiologist ventilated the patient's lung by inserting laryngeal mask airway. The purpose of this article is to increase awareness among anesthetists and surgeons about the anatomical and pathophysiological changes in these syndrome which may lead to severe airway problems and complications in perioperative period
ABSTRACT
Foreign body ingestion is a common complaint in the pediatric emergency departments. Esophageal foreign body is a potentially serious cause of morbidity and mortality in children. Here we report an interesting case of disk battery ingestion resulting tracheo-esophageal fistula [TEF]. The surgery for repair of TEF was done one month after ingestion. A brief review of the diagnosis and management of esophageal foreign bodies is presented with particular focus on ingested disk batteries