ABSTRACT
A review of 364 rigid bronchoscopies in children is presented of whom 55% were younger than 3 years old. The commonest diagnoses in the under 1 year old group were related to congenital anomalies, in the 1-3 year group to inhaled foreign bodies, and in the over 3 year group to bronchiectasis. It is noted that some 30-40% of the tests could have been undertaken with a flexible bronchoscope, but it is suggested that the advantages of the flexible instrument in children with lung disease, as distinct from upper airway disease, are less than in adult practice. Clear benefits for the management of the patient should be obvious before undertaking bronchoscopy in children, and careful consideration should be given to the type of instrument most likely to provide the results desired.
Subject(s)
Bronchoscopes , Respiratory System Abnormalities , Respiratory Tract Diseases/diagnosis , Adolescent , Age Factors , Anesthesia, General , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Preanesthetic MedicationSubject(s)
Anesthesia, Intravenous , Anti-Anxiety Agents , Electric Countershock , Flunitrazepam , HumansABSTRACT
A simple method for achieving satisfactory regional anaesthesia for a wide range of hand surgery is presented. It entails separate attention to the two aims of regional anaesthesia, namely analgesia of the tourniquet and of the operative site. This study of 149 patients indicated that (a) subcutaneous ring anaesthesia produced excellent tourniquet analgesia, both in the forearm as well as the upper arm; (b) a tourniquet applied to the forearm provided excellent regional ischaemia in 98% of our cases, contrary to what has been previously accepted. The advantages of this method are its safety and simplicity even for the relatively untrained surgeon. It also obviates the need for brachial plexus blocks, intravenous regional or general anaesthesia with all their drawbacks.
