bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of sleep and quality of life before and after coronary artery bypass grafting: A pilot study
Authors: M Ulla , E Jerker , B Claes , KF Elisabeth 
Published: February 2007

Edéll‐Gustafsson UM, Hetta JE, Arén CB & Hamrin EKF. International Journal of Nursing Practice 1997;3: 239–246Measurement of sleep and quality of life before and after coronary artery bypass grafting: A pilot studyThe aim of this study was to: (i) test different instruments that focused on sleep, quality of life and personal adjustment in order to evaluate the usefulness of these instruments in a larger study; and (ii) to describe self perceptions of sleep and life situation by patients who had undergone coronary artery bypass grafting (CABG). A one‐group pre‐test repeated post‐test design was used. Six men aged between 51 and 70 years were interviewed, and 24 h polysomnographic recordings were performed before and after the operation. The interviews indicated disturbed sleep and changes in behaviour and mental state immediately postoperatively. Postoperatively the polysomnographic recordings revealed a significant decrease in mean duration of sleep, mean percentage of stage 3–4 sleep and mean rapid eye movement (REM) sleep. One month after surgery the quality of life was improved, while moderate anxiety and sensation of incisional pain persisted. The measurements used in this pilot study provide valuable information into the understanding of altered sleep, quality of life and personal adjustment following CABG.
Assisted local anaesthesia for endoscopic dacryocystorhinostomy
Authors: Howden Juliette , McCluskey Peter , O’Sullivan Greg , Ghabrial Raf 
Published: February 2007

AbstractBackground:  Endoscopic dacryocystorhinostomy is traditionally performed under general anaesthesia. However, there are reports in the literature of various local anaesthetic techniques with or without sedation for this procedure. An effective and acceptable local anaesthetic technique enables the avoidance of the risks associated with general anaesthesia, particularly for elderly patients, with the added benefit of reduced bleeding, reduced nausea and vomiting, and reduced length of hospital stay and thus health care cost savings. This study aims to evaluate the safety and patient acceptance of a minimally invasive assisted local anaesthetic technique for endoscopic dacryocystorhinostomy.Methods:  A prospective questionnaire‐based study is presented of 24 consecutive adult patients who underwent 26 endoscopic dacryocystorhinostomies in a day surgery including 22 primary and four revision procedures performed by one surgeon under local anaesthesia and sedation over a 4‐month period.Results:  Apart from persistent postoperative vomiting in one patient there were no anaesthetic complications. There were no instances of epistaxis. The mean pain score on a visual analogue scale of 0–10 was 1.56 and 56% reported no pain. Ninety‐two per cent would recommend the procedure to others.Conclusion:  This assisted local anaesthetic technique for endoscopic dacryocystorhinostomy is safe and acceptable to patients.
SAFETY OF TOTAL THYROIDECTOMY
Authors: Serpell Jonathan W. , Phan Diana 
Published: February 2007

Background: Total thyroidectomy is the preferred operation for multinodular goitre, Graves’ disease and thyroid cancer. This study reviewed prospectively collected data on a personal consecutive series of 336 total thyroidectomies to assess whether results reported in world centres of excellence could also be achieved elsewhere.Methods: Between 1991 and 2004, 336 total thyroidectomies (85% over the last 6 years) of median age 53 years (13–86 years) and male : female ratio of 1:4.3 were undertaken for multinodular goitre 232 (69%), Graves’ disease 26 (7.7%), thyroid cancer 60 (17.9%) and other benign conditions 17 (5.4%). Thirty‐nine patients had 2‐stage procedures. No patient required median sternotomy. Parathyroid autotransplantation was carried out in 43 (12.8%).Results: Permanent unilateral recurrent laryngeal nerve palsy occurred in 0.3% and permanent hypoparathyroidism in 1.8%. Significant temporary hypocalcaemia occurred in 13.4%. Non‐significant temporary hypocalcaemia occurred in 23.8%, resulting in an overall rate of hypocalcaemia of 38.9% for the total series. Hypocalcaemia was more common after 1‐stage compared with 2‐stage surgeries (P < 0.001). Temporary hypocalcaemia was commoner after surgery for Graves’ disease than surgery for other conditions. The rate of postoperative haemorrhage was 0.9% and wound infection, 1.5%. There was no postoperative mortality.Conclusion: Total thyroidectomy removes the disease process completely, lowers local recurrence rates and avoids the substantial risks of reoperative surgery. Total thyroidectomy is safe and can be carried out with low complication rates that are equal to world centres of excellence.
Button battery ingestion and its sequelae, implications for the anaesthetist: a case report and review
Authors: WESTBROOK J.L. , STEVENS J.E. 
Published: February 2007

SummaryThis case report describes the serious life‐threatening complication of oesophageal perforation and subsequent stricturing requiring resection, observed after the ingestion of a button battery. The current literature is reviewed, a treatment plan is suggested, and greater awareness amongst the general public, manufacturers and medical personnel of the potential risks recommended.
Bronchoscopic findings and treatment in congenital tracheo‐oesophageal fistula
Authors: MD J. HOLZKI 
Published: February 2007

SummaryBronchoscopy was performed in 161 patients with oesophageal atresia or tracheo‐oesophageal fistula without atresia between 1983 and 1991 at The Children's Hospital, Cologne, Germany. Twelve patients had oesophageal atresia without fistula, and seven patients had tracheo‐oesophageal fistula without atresia. In the 149 patients with congenital tracheo‐oesophageal fistula a total of 154 fistulae were found. In the five patients with two fistulae the second was detected in one patient only during primary anastomosis, and in the other four patients by bronchoscopy up to 18 years after the original operation.The study group comprised 113 newborn infants and 48 patients admitted for evaluation of severe airway problems. A very high proportion (89%) of the newborn infants had an associated abnormality of the respiratory tract. In the other 48 patients, all showed a tracheobronchial abnormality. Fourteen of these patients required tracheal surgery and 12 improved following oesophageal surgery. A comparison between the incidence of the types of oesophageal atresia previously described and this series showed a marked difference, which is probably due to greater precision of the location of the fistula demonstrated by bronchoscopy. Bronchoscopy should be undertaken in all patients with oesophageal atresia with a tracheo‐oesophageal fistula.
Anaesthesia and the mucopolysaccharidoses: a review of patients treated by bone marrow transplantation
Authors: FCAnaes A. MAHONEY , FFARACS N. SONI , MRCP A. VELLODI 
Published: February 2007

SummaryThe mucopolysaccharidoses present many potential difficulties to the anaesthetist. A review was undertaken of the last 10 years' experience at a paediatric hospital which has a special interest in the treatment of these conditions using bone marrow transplantation. Thirty‐five patients underwent 150 general anaesthetics. There was a high incidence of airway problems and cardiorespiratory disease. Laryngoscopy and tracheal intubation was difficult in 40% of patients with Hurler's syndrome and 71% of those with Hunter's syndrome. A tracheal tube of smaller than predicted internal diameter was commonly required. Cardiorespiratory problems included both myocardial and valvular disease which could often be identified preoperatively as could kyphoscoliosis. The implications for anaesthesia are discussed.
Anaesthesia for magnetic resonance imaging of children
Authors: SURY M. R. J. , JOHNSTONE G. , BINGHAM R. M. 
Published: February 2007

SummaryChildren undergoing magnetic resonance imaging (MRI) often require anaesthesia. This article presents the theory of MRI, its hazards, the limitations on equipment and monitoring and explains how the anaesthetic service is provided at the Hospital for Sick Children, London. The design of an MRI department should include an anaesthetic area next to the scanning room. In this area patients may not only be induced but also recover safely without any restrictions.
Implications of the National Confidential Enquiry into Perioperative Deaths for paediatric anaesthesia*
Authors: LUNN J. N. 
Published: February 2007

SummaryData is quoted from the report of the enquiry to support arguments in favour of some changes in the organization both of training of anaesthetists and of the delivery of anaesthetic care to children. The recommendations of the enquiry are valid in the United Kingdom and may be as applicable elsewhere. Their implementation will pose problems which are capable of solution.
Duration of action of an equipotent dose of vecuronium in infants and in children
Authors: TAIVAINEN T. , PRAEFORT L. , MERETOJA O. A. 
Published: February 2007

SummaryDuring general anaesthesia without any volatile anaesthetic agents, ten infants and ten children received incremental doses of vecuronium to achieve a 95% neuromuscular block. Thereafter, the thenar electromyographic response was allowed to recover spontaneously. Total dose of vecuronium to establish a 95.0 ± 0.5% (mean ± SEM) neuromuscular block was 66% greater for children than for infants (73 ± 4 vs. 44 ± 4 μg·kg−1, P < 0.0001). However, recovery index and time to complete recovery of the neuromuscular function were 88 and 89% longer, respectively, in infants than in children (P < 0.0001). These results of the effect of an equipotent dose of vecuronium in infants and in children confirm that vecuronium is a long acting neuromuscular blocking agent in infants.
Central venous cannulation in infants and children: a comparison of internal and external jugular vein approaches
Authors: VERGHESE S.T. , PATEL R.I. , HANNALLAH R.S. 
Published: February 2007

SummaryWe prospectively evaluated success rate and complications associated with 436 internal (IJ) and external (EJ) jugular approaches to central venous cannulation in 377 paediatric patients. Variables studied included the route of insertion, success rate, cannulation time, intraoperative and postoperative catheter‐related complications. The overall success rate and the frequency of complications were higher with the IJ than with the EJ approach. Cannulation with the EJ approach was more successful in older patients than in younger ones, making EJ a more attractive route for central venous cannulation in older children. While the inconsistent final position of the catheter tip makes EJ a less reliable technique for central venous pressure monitoring, it does not limit its usefulness for infusion of vasoactive drugs. If monitoring of filling pressures is desired, the IJ approach is a better choice, despite its higher risk of complications.
Spinal anaesthesia in former preterm infants
Authors: GERBER A.CH. , BAITELLA L.C. , DANGEL P.H. 
Published: February 2007

SummarySpinal anaesthesia for herniotomies in former preterm infants at risk from postoperative apnoea was investigated in a prospective, uncontrolled study involving 164 infants. Hyperbaric tetracaine (0.5 mg·kg−1) with adrenaline was used. In 152 patients (92.7%) spinal blockade was achieved, in 12 (7.3%) general anaesthesia was given after unsuccessful lumbar puncture. Fifteen patients required supplementation of spinal anaesthesia. Intraoperative complications included 2 apnoea during lumbar puncture and 5 total spinal blocks. By the end of surgery all complications had been resolved. No patient with spinal anaesthesia developed prolonged apnoea after surgery. Spinal anaesthesia in former preterm infants seems to avoid prolonged postoperative apnoea. Disadvantages of the technique were failures due to technical difficulties and excessive spread of spinal blockade.
Anaesthetic considerations in a child with adrenoleukodystrophy
Authors: NISHINA KAHORU , MIKAWA KATSUYA , MAEKAWA NOBUHIRO , GOTO RYOKICHI , TANAKA OSAMU , YAKU HIDEAKI , OBARA HIDEFUMI 
Published: February 2007

SummaryA child with asymptomatic adrenoleukodystrophy (ALD) who uneventfully underwent an operation for undescended testis under halothane‐nitrous oxide anaesthesia is presented. The normal hormonal responses to surgical stress were observed. The potential problems of disorders of the adrenal cortex, the central nervous system, and skeletal muscle associated with the condition are discussed. Rapid‐ACTH test may be a useful method for the evaluation of the adrenocortical function in this disease. It is proposed that a patient with ALD should receive a single dose of steroid regardless of the result of the rapid ACTH test.
Acute parotitis: an unusual paediatric complication
Authors: ZAGNOEV MICHAEL , McCLOSKEY JOHN J. , KETTRICK ROBERT G. 
Published: February 2007

SummaryPatients undergoing procedures in the prone position can develop many pressure related complications. This report describes the post‐operative course of a 10‐year‐old girl who developed acute parotitis following a prolonged procedure performed with her in the prone position. The management of this problem is briefly discussed.
Post‐operative pain in children after day case surgery
Authors: KNIGHT JULIAN C. 
Published: February 2007

SummaryThe increasing use of paediatric day case surgery requires assessment of the effectiveness of post‐operative analgesia. A prospective epidemiological study of ninety‐eight patients undergoing day case surgery looked at pain assessment using a self report Faces scale and a numerical rating scale for parents and nursing staff. An inpatient record was combined with a home questionnaire detailing pain assessment and analgesic use over a 48 h period. Patients undergoing circumcision with a penile ring block experienced significant degrees of post‐operative pain, had high levels of use of paracetamol at home, and their first night of sleep was frequently disturbed. High levels of opioid use were found. Comparison between assessors indicated parents tended to score their child's pain higher than nursing staff in hospital. Minor paediatric surgical procedures, particularly circumcision, may be associated with considerable post‐operative pain and assumptions must not be made about the effectiveness of analgesia, especially in the home.
Mivacurium in children with Duchenne muscular dystrophy
Authors: TOBIAS JOSEPH D. , ATWOOD ROBERT 
Published: February 2007

SummaryThe authors retrospectively reviewed their experience with mivacurium for neuromuscular blockade in seven children with Duchenne muscular dystrophy. Mivacurium was administered to seven children ranging in age from 8.3 to 14.4 years and in weight from 29 kg to 68 kg during either posterior spinal fusion or lower extremity release. An initial bolus dose of 0.2 mg·kg−1 was followed by a continuous infusion. Neuromuscular blockade was monitored with a standard twitch monitor and the TOF (2 Hz for 2 s). Complete suppression of all four twitches occurred in 1.5 to 2.6 min. The continuous infusion was started with the return of the first twitch and adjusted to maintain one twitch. Time to recovery of the first twitch varied from 12 to 18 min. Continuous infusion requirements varied from 3 to 20 μg·kg−1 with an average for the case of less than 10 μg·kg−1 min−1 in five of the seven patients. A moderate increase in sensitivity to mivacurium in this patient population is suggested by a decrease in infusion requirements and a prolonged effect following the initial dose.
Plasma concentrations of bupivacaine in young infants after continuous epidural infusion
Authors: LARSSON B.A. , OLSSON G.L. , LÖNNQVIST P.A. 
Published: February 2007

SummaryThis study reports plasma bupivacaine concentration in seven infants who during major abdominal surgery received lumbar epidural or caudal block anaesthesia. Plasma concentrations (CP) were measured postoperatively after six and twelve h of continuous infusion. Postnatal age ranged from one day to seven months. The local anaesthetic block was performed after induction of anaesthesia. Postoperatively bupivacaine 1.25‐2.5 mg·ml−1 without adrenaline was infused at a rate of 0.5 to 0.83 mg·kg−1·h−1. After six h of infusion the mean value measured was 1.59 μg·ml−1 (range 1.2‐1.94 μg·ml−1). After 12 h the mean value measured was 2.06 μg·ml−1 (range 1.53‐2.98 μg·ml−1). A marked increase in bupivacaine plasma concentration was seen between six and 12 hours of infusion. Bupivacaine plasma concentration never exceeded 4 μg·ml−1. Adverse effects that possibly were due to a toxic reaction to bupivacaine were seen in three patients. In conclusion, the dose administered in this study appears to be high and cannot be recommended as safe dosage in this age group.;
CRIES: a new neonatal postoperative pain measurement score. Initial testing of validity and reliability
Authors: KRECHEL SUSAN W. , BILDNER JUDY 
Published: February 2007

SummaryWe have developed a neonatal pain assessment tool CRIES. The tool is a ten point scale similar to the APGAR score (Apgar 1953). It is an acronym of five physiological and behavioural variables previously shown to be associated with neonatal pain. C—Crying; R—Requires increased oxygen administration; I—Increased vital signs; E—Expression; S—Sleeplessness. We have tested CRIES for validity and reliability. This report is the result of that testing. We have found CRIES to be valid, reliable and well accepted by neonatal nurses.
A survey of interhospital transport of the critically ill child in the United Kingdom
Authors: DRYDEN COLIN M. , MORTON NEIL S. 
Published: February 2007

SummaryNineteen paediatric intensive care units were surveyed by questionnaire to provide information on the number of interhospital transfers, the experience of personal accompanying the critically ill child and the equipment available to maintain intensive care during transfer. Replies were received from 17 units. An estimated 800 transfers are performed annually. Three units routinely send intensive care staff to collect patients with an estimated 60% of transfers performed by a variety of staff from referring hospitals. Most respondents believed that existing arrangements for transfer were unsatisfactory, but only four units said that transfer may be prevented or delayed by lack of facilities. We believe that any plan to centralize paediatric intensive care in the UK should also include the means by which to transfer the patient without increasing the risk to the patient.
Intrathecal morphine (ITM) for postoperative pain control in children: a comparison with nalbuphine patient controlled analgesia (PCA)
Authors: KRECHEL SUSAN W. , HELIKSON MARY ALICE , KITTLE DIAN , EGGERS G.W.N. 
Published: February 2007

SummaryThis is a retrospective study covering the ten‐year period 1984–1993. Single shot spinal morphine (ITM) is compared with PCA nalbuphine for postoperative pain relief in children having abdominal or thoracic procedures. The records of 52 patients meeting selection criteria were examined. Nursing and physician notations were reviewed for hourly pain assessments, evidence of associated complications, respiratory depression, nausea and or vomiting, pruritus, and urinary retention. ITM provided significantly better pain relief (2.2 h in pain) during the first 24 h postoperatively than PCA nalbuphine (9.2 h in pain). With the exception of urinary retention which was significantly more frequent following ITM (58.6%) compared to PCA nalbuphine (8.7%), narcotic related complications were not different between the two groups. No difference in duration of hospital stay or ICU stay could be demonstrated. We conclude that ITM provides better pain relief, without more serious complications, than PCA nalbuphine. We recommend it as a safe, effective technique to treat postoperative pain in children following thoracic or upper abdominal procedures.
Nitric oxide in the management of persistent pulmonary hypertension of the newborn—an unusual cause of failure
Authors: JERWOOD D.C. , STOKES M.A. 
Published: February 2007

SummaryA diagnosis of persistent pulmonary hypertension of the newborn should be reviewed if there is a failure to respond to appropriate treatment. We report a case in which both conventional therapy and inhaled nitric oxide failed to break the cycle of right‐to‐left shunting. Reassessment revealed a massive pulmonary arteriovenous malformation for which surgery was successfully performed in the neonatal period.
The pharmacokinetics of bupivacaine following interpleural nerve block in infants of very low birthweight
Authors: P.J. WESTON MBChB, FRACP  , BOURCHIER D. 
Published: February 2007

SUMMARYInfants of very low birthweight (VLBW) who underwent thoracotomy were given 2.0 mg·kg‐1 of bupivacaine by the intrapleural route, and serial blood levels were taken to determine the pharmacokinetic profile in this group of babies. It was apparent that the half life was longer, clearance lower, and volume of distribution greater than in term infants. Although the drug did not reach toxic levels at this dose, caution should be observed when redosing as the accumulation of the drug may be unpredictable.
Sevoflurane elimination kinetics in children
Authors: LANDAIS A. , SAINT‐MAURICE Cl. , HAMZA J. , ROBICHON J. , McGEE K. 
Published: February 2007

SUMMARYWe compared the rates of elimination of sevoflurane and halothane in 29 children, aged between one and seven years, undergoing ambulatory anaesthesia. Analgesia was provided by fentanyl and muscle relaxation by atracurium. Anaesthesia was maintained by inhalation of one MAC of either sevoflurane or halothane, based on an equipotent concentration of each agent for the age of the child. Following simultaneous discontinuation of N2O and the inhalational agent, the equation describing N2O washout was identical in the presence of halothane and sevoflurane, showing that there was no effect of the volatile agent on the rate of N2O elimination. The elimination of sevoflurane and N2O give similar types of equations. Halothane elimination gives a logarithmic type of equation, showing a slower release, corresponding to residual tissue content.
Anaesthetic management of the child with myotonic dystrophy: epidural anaesthesia as an alternative to general anaesthesia
Authors: TOBIAS JOSEPH D. 
Published: February 2007

SUMMARYAn 11‐year‐old boy with myotonic dystrophy required anaesthesia for a lower extremity orthopaedic procedure. The management of patients with myotonic dystrophy is discussed including the use of epidural anaesthesia with a continuous chloroprocaine infusion as an alternative to general anaesthesia.