bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retracted: Prevention of postoperative vomiting with granisetron in paediatric patients with and without a history of motion sickness
Authors: Fujii Yoshitaka , Saitoh Yuhji , Tanaka Hiroyoshi , Toyooka Hidenori 
Published: March 2003

SummaryA history of motion sickness is one of the patient‐related factors associated with postoperative emesis. This prospective, randomized, double‐blind, placebo‐controlled study was undertaken to assess the efficacy of granisetron, a selective 5‐hydroxytryptamine type 3 receptor antagonist, for preventing postoperative vomiting after tonsillectomy in 120 children with (n=60) and without (n=60) a history of motion sickness. Patients received a single dose of granisetron (40 μg·kg−1) or placebo (saline) (n=30 of each) intravenously after an inhalation induction of anaesthesia. A complete response, defined as no vomiting, no retching and no need for another rescue medication, during the first 24 h after anaesthesia was 77% and 13% in patients with a history of motion sickness who had received granisetron or placebo, respectively; the corresponding incidence was 83% and 40% in those without it (P< 0.05; χ2 test with Yates’ continuity correction). No clinically serious adverse effects due to the study drug were observed in any of the groups. In conclusion, prophylactic antiemetic therapy with granisetron is effective for preventing postoperative emesis in children with a history of motion sickness as well as in those without it.
Paracetamol‐induced fulminant hepatic failure in a child after 5 days of therapeutic doses
Authors: Morton Neil S. , Arana Amaia 
Published: March 2003

SummaryWe report the case of a two and a half year‐old girl who developed fulminant hepatic failure following 5 days of regular oral ingestion of paracetamol, approximately 90 mg·kg−1·day−1. She presented with the typical findings of hepatomegaly, encephalopathy, high ammonia levels, high transaminases, hypoglycaemia and lactic acidosis. After stabilization, she was transferred to a specialist paediatric liver failure unit and fortunately she made a full recovery with intensive medical management.
Failure of the laryngeal mask to secure the airway in a patient with Hunter's syndrome (mucopolysaccharidosis type II)
Authors: BUSONI PAOLO , FOGNANI GIULIANA 
Published: March 2003

SummaryWe present a case‐study of a boy with Hunter's syndrome (mucopolysaccharidosis type II) and stridor in which a laryngeal mask airway (LMA) failed to secure airway control. A rigid bronchoscopy was performed and a polypoid formation discovered. We believe that the use of the LMA could explain the laryngeal obstruction in this child.
Computerized tomography of the lungs and arterial oxygen tension studies during apnoea in anaesthetized young lambs
Authors: Law R.C. , Van Der Walt J.H. 
Published: March 2003

SummaryComputerized tomography (CT) of the lungs and arterial oxygen tension studies were performed during general anaesthesia in an animal model to understand changes in pulmonary atelectasis associated with anaesthesia in children during a 2 min apnoeic period. Six anaesthetized lambs were subjected to three periods of apnoea lasting 2 min each. A series of 10 mm CT transaxial views were taken at three levels of the chest and arterial blood gases were analysed at the start of the apnoeic period (baseline) and again every 30 s during the apnoeic period. The areas of atelectasis were measured using the extended Hounsfield scale. The results confirmed that significant background atelectasis was associated with general anaesthesia as found in adult human studies, but failed to demonstrate any increase in atelectasis during the period of induced apnoea. The decline in arterial oxygen tension in this study could be explained due to simple utilization of oxygen in keeping with physiological principles.
The effect of induced hypothermia on the duration of action of atracurium when given by infusion to critically ill children
Authors: Playfor S.D. , Thomas David A. , Choonara Imti 
Published: March 2003

SummaryThe aim of the study was to investigate the effect of induced hypothermia on the offset time of atracurium when given by continuous infusion to critically ill children. Over a period of 8 months, six mechanically ventilated children had a steady‐state infusion of atracurium discontinued. The offset time of atracurium was assessed by train‐of‐four (TOF) stimulation of the ulnar nerve; recording the time taken to reach a TOF ratio of 0.9. Nine assessments were carried out. The mean offset time of atracurium was 82 min. This was significantly longer than in patients with temperatures within the normal physiological range. When considering all assessments, performed both in hypothermic and normothermic patients, there is a strong correlation between rectal temperature and the offset time of atracurium. Prolonged moderate hypothermia has a very significant effect on the offset time of atracurium when given by infusion to critically ill children.
Acute pulmonary haemorrhage in an infant during induction of general anaesthesia
Authors: Tripi Paul A. , Modlin Sheryl , Sorenson W.G. , Dearborn Dorr G. 
Published: March 2003

SummaryPulmonary haemorrhage is a rare, life‐threatening complication of anaesthesia. This report describes the anaesthetic management of an infant who developed laryngospasm and pulmonary haemorrhage during general anaesthesia. The infant was subsequently found to have prior exposure to a fungus, Stachybotrys chartarum, which produces mycotoxins that may have produced capillary fragility in the infant's rapidly growing lungs.
Preliminary experience with the Doppler ultrasound guided vascular access needle in paediatric patients
Authors: Macintyre P.A. , Samra G. , Hatch D.J. 
Published: March 2003

SummaryPercutaneous cannulation of the internal jugular vein (IJV) in infants and children may be technically difficult and can lead to complications. Various techniques exist to achieve successful cannulation and to reduce the rate of complications. We report the use of the Doppler ultrasound guided vascular access needle (the SMART needle) for IJV cannulation in 10 infants and young children (mean age 3.7 months) weighing less than 10 kg (mean weight 5.5 kg) who were to undergo cardiac surgery at Great Ormond Street Hospital for Children. Successful cannulation was achieved in six out of 10 patients with haematoma complicating the procedure in two patients. We believe this is the first reported use of this device for cannulation of the IJV in this patient group.
Paediatric lumbar epidurals: a comparison of 21‐G and 23‐G catheters in patients weighing less than 10 kg
Authors: Sage Frederic J. , Lloyd Thomas Adrian R. , Howard Richard F. 
Published: March 2003

SummaryUsing the database of our pain management team, we examined the records of 254 patients weighing between 4.5 kg and 10 kg who received an epidural for postoperative analgesia. We looked at the incidence of catheter related problems in two groups of patients in whom either a 21‐G (18‐G short Tuohy needle) or a 23‐G catheter (19‐G short Tuohy needle) was used. There was a significantly higher incidence of difficulty in threading the catheter, kinking and occlusion in the 23‐G catheter group. There were more leaks in the 21‐G catheter group but the difference was not significant and both groups had a comparable incidence of clinically relevant leakages. No dural tap or difficulty in using either needle were reported.
Spinal anaesthesia for insertion of a peritoneal dialysis catheter in a neonate
Authors: Mccormick A.S.M. , Thomas V.L. 
Published: March 2003

SummaryA 5‐day‐old neonate born at term presented in renal failure for insertion of a peritoneal dialysis catheter. This was successfully achieved with spinal anaesthesia, with no intra‐ or postoperative complications. Regional techniques are considered suitable for an increasing variety of procedures in patients in whom the risks of general anaesthesia are significant.
Persistent anaphylactic reaction after induction with thiopentone and cisatracurium
Authors: Briassoulis George , Hatzis Tassos , Mammi Panagoula , Alikatora Anna 
Published: March 2003

SummaryA 6‐year‐old boy presented for surgery for phimosis. The anaesthetic technique included intravenous induction with thiopentone and neuromuscular blockade with cisatracurium. Severe persistent bronchospasm and central cyanosis followed the administration of these drugs. A continuous i.v. infusion of epinephrine at 0.2 μg·kg−1·min−1 was necessary to break the severe refractory bronchial hyperresponsiveness. There was no previous exposure to anaesthetic drugs and no definite family history of allergy. Through increased serum eosinophil cationic protein, tryptase and histamine levels and IgE levels specific to cisatracurium, we demonstrated an IgE‐mediated anaphylactic reaction to cisatracurium in the child's first exposure to this new neuromuscular blocking agent. Anaphylactic reactions to new anaesthetic drugs may be challenging to recognize and treat during general anaesthesia in children. The pathogenesis, diagnosis and management of life threatening persistent allergic reactions to intravenous anaesthetics are discussed.
Regional anaesthesia decreases the need for postoperative mechanical ventilation in very low birth weight infants undergoing herniorrhaphy
Authors: Huang Jeffrey Jianhong , Hirshberg Gary 
Published: March 2003

Background: We were interested to know whether regional anaesthesia allowed improved respiratory function postoperatively in very low birth weight babies. Methods: We performed a retrospective study to examine the association between regional anaesthesia and postoperative ventilation after herniorrhaphy in very low birth weight infants. Thirty‐four prematurely born infants underwent herniorrhaphy from 1995 to 1997 at St Louis Children Hospital. Eighteen patients had general anaesthesia, 16 had regional anaesthesia. The mean gestational age was 26 weeks, mean postconceptual age at surgery was 38 weeks, mean birth weight was 860 g. Results: There was significant difference in postoperative ventilation support requirements between the two study groups (7/18 versus 1/16, P < 0.05). Conclusions: Regional anaesthesia decreases the need for postoperative ventilatory support requirements in very low birth weight infants undergoing herniorrhaphy.
The use of the cuffed oropharyngeal airway in paediatric patients
Authors: BUSSOLIN L , BUSONI P 
Published: March 2003

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.
Diffusion of ketoprofen into the cerebrospinal fluid of young children
Authors: KOKKI HANNU , KARVINEN MARKO , JEKUNEN ANTTI 
Published: March 2003

Background: The objective was to examine whether or not ketoprofen enters the cerebrospinal fluid after a single oral dose of 1 mg·kg–1 syrup, and to find out what is the lowest plasma concentration that will achieve a measurable level in the cerebrospinal fluid. Methods: We measured ketoprofen concentrations both in plasma and cerebrospinal fluid of 10 young and healthy children (aged 9–86 months) after surgery with spinal anaesthesia. Samples of cerebrospinal fluid were collected 30 min after drug administration, at the same time as venous blood samples. A validated high‐performance liquid chromatography method with a lower limit of 0.02 μg·ml–1 was used to detect ketoprofen concentrations in cerebrospinal fluid and plasma. Results: Ketoprofen was detectable in the cerebrospinal fluid only in the child who had the highest plasma concentration, 7.4 μg·ml–1, while at plasma concentrations 6.5 μg·ml–1 or less, cerebrospinal fluid (CSF) concentrations remained unmeasurable. The detected CSF/plasma ratio was 0.008. Conclusions: These results indicate that ketoprofen at a dose of 1 mg·kg–1 is too low to produce measurable CSF levels within 30 min of oral administration.
Retracted: Preoperative oral granisetron for the prevention of vomiting following paediatric surgery
Authors: Fujii Yoshitaka , Tanaka Hiritoshi 
Published: March 2003

Background: We evaluated the efficacy of granisetron, 5‐hydroxytryptamine type 3 receptor antagonist, given orally, preoperatively, for the prevention of postoperative vomiting in children undergoing general anaesthesia for surgery (inguinal hernia, phimosis‐circumcision).Methods: In a randomized, double‐blinded manner, 100 children, ASA physical status I, aged 4–11 years, received orally placebo or granisetron at three different doses (20 μg·kg–1, 40 μg·kg–1, 80 μg·kg–1) 60 min before surgery (n=25 of each). The same standard general anaesthetic technique was used.Results: The percentage of patients being emesis‐free during 0–6 h after anaesthesia was 56% with placebo, 64% with graniseron 20 μg·kg–1 (P=0.773), 88% with granisetron 40 μg·kg–1 (P=0.027) and 92% with granisetron 80 μg·kg–1 (P=0.01); the corresponding rate during 6–24 h after anaesthesia was 60%, 68% (P=0.768), 92% (P=0.02) and 92% (P=0.02) (P‐values versus placebo). No clinically serious adverse events were observed in any of the groups.Conclusions: In summary, preoperative oral granisetron 40 μg·kg–1 is effective for the prevention of vomiting following paediatric surgery (inguinal hernia, phimosis‐circumcision). Increasing the doses to 80 μg·kg–1 provides no demonstrable additional benefit.
Time‐course of action of rocuronium 0.3 mg·kg−1 in children with and without endstage renal failure
Authors: Driessen Jacques J. , Robertson Eric N. , Van Egmond Jan , Booij Leo H.D.J. 
Published: March 2003

Summary Background: The time‐course of the neuromuscular effects of rocuronium 0.3 mg·kg−1 during nitrous oxide‐halothane anaesthesia in children with and without renal failure is unknown. This study compared the neuromuscular blocking effects in these groups. Methods: The study was approved by the Hospital Ethical Committee. In the control group, 14 healthy children without renal disease were scheduled for various elective surgical procedures. Sixteen children with endstage renal failure, 14 of whom were already on renal dialysis, were scheduled for (re)placement of dialysis catheters (n=14) or for renal transplantation (n=2). Anaesthesia was induced and maintained with halothane and nitrous oxide in oxygen. Acceleromyographic thumb adduction after supramaximal ulnar nerve stimulation was recorded using train‐of‐four stimulation every 15 s. The onset time, the time to recovery of the first twitch to 25% or 75% and to recovery of a train‐of‐four ratio of 0.7 after rocuronium 0.3 mg·kg−1 were measured. Statistical analysis was performed with Student's t‐test. P < 0.05 was considered statistically significant. Results: The onset time was longer in children with renal failure (139 s, SD=71) than in control children (87 s, SD=43) (P=0.02). There were no significant differences in the duration of action of rocuronium between children without renal failure and in 15 out of 16 children with renal failure. Conclusions: In children with renal failure, aged over 1 year, a single bolus dose of rocuronium 0.3 mg·kg−1 does not cause a prolonged block, but has a slower onset than in healthy children.
Detection of peripherally inserted central catheter occlusion by in‐line pressure monitoring
Authors: Arai Junichi , Mouri Youko , Miyamoto Yasuyuki 
Published: March 2003

SummaryBackground: Peripherally inserted central catheters (PICC) are being increasingly used in neonatal practice. Their use is not without technical difficulty. This report describes the use of continuous pressure monitoring to detect catheter occlusion in critically ill neonates.Methods: In‐line venous pressure of the PICC line was monitored by pressure transducer in neonates; 28‐gauge 20 cm PICC or 29‐gauge 25 cm PICC were used.Results: In‐line pressure of the PICC was monitored 64 times in 50 neonates. Increases in the in‐line pressure were observed when the catheter tip was against the vessel wall and the catheter was obstructed partially or completely. Decreases were observed when the infusion syringe was changed and when an inappropriate infusion rate was set. Two infants experienced marked variations of blood pressure due to intermittent catheter occlusion of the tip against the vessel wall. These infants were receiving dopamine via a PICC line.Conclusions: In critically ill infants, in‐line pressure monitoring of the PICC is helpful in detecting the occlusion of the catheter.
Brachial plexus anaesthesia in children: lateral infraclavicular vs axillary approach
Authors: Fleischmann E. , Marhofer P. , Greher M. , Waltl B. , Sitzwohl C. , Kapral S. 
Published: March 2003

Summary Background: Brachial plexus blockade is a well‐established technique in upper‐limb surgery. In paediatric patients, the axillary route is usually preferred to infraclavicular approaches because of safety considerations. Recent reports on a lateral infraclavicular approach offering greater safety in adults prompted us to perform a prospective randomized study to assess the analgesic efficacy of axillary vs lateral vertical infraclavicular brachial plexus (LVIBP) blocks in paediatric trauma surgery. Methods: Forty paediatric trauma patients (ASA physical status I and II, age range 1–10 years) scheduled for forearm or hand surgery were randomly assigned to either axillary brachial plexus (ABP group) or LVIBP group blocks using 0.5 ml·kg−1 ropivacaine 0.5%. Sensory blockade was evaluated by a visual analogue score and Vester–Andersen's criteria, the distribution of sensory and motor blockade was evaluated by a simplified pinprick test and motor tests. Results: In the LVIBP group, Vester–Andersen's criteria were met by 100% of children, compared with 80% in the ABP group (P=0.035). Based on all assessable children, sensory blockade in the primary sensory regions of various nerves was significantly more effective in the LVIBP group (axillary: P < 0.0001; musculocutaneous: P=0.002; medial brachial cutaneous; P=0.008). Motor blockade was also significantly more effective (axillary: P < 0.0001; musculocutaneous: P=0.003). No major complications were observed in either group. Discussion: We conclude that LVIBP blocks can be safely performed in children and that they add to the spectrum of sensory and motor blockade seen with the axillary approach.
Systemic hypertensive disease and the feline fundus
Authors: Crispin Sheila M. , Mould John R. B. 
Published: March 2003

AbstractThe fundoscopic appearance and some of the histopathological findings of arterial hypertension in the cat are reviewed in relation to the anatomical and physiological features that place retinal function at particular risk when the eye is subjected to sustained increased arterial blood pressure. The fundus changes fall into three categories: hypertensive retinopathy, hypertensive choroidopathy and hypertensive optic neuropathy, and information from cases with confirmed arterial hypertensive disease is used to provide a basis for discussion and future investigation.
Spontaneous cataracts in laboratory rabbits
Authors: Munger Robert J. , Langevin Nicholas , Podval J. 
Published: March 2003

AbstractObjective To document the occurrence and incidence of spontaneously occurring cataracts in older New Zealand White (NZW) and New Zealand White × New Zealand Red (NZW × NZR – F1) rabbits during prescreening examinations at Alcon Laboratories.Procedures A retrospective study was conducted on prescreening examination records of NZW and NZW × NZR (F1) rabbits at Alcon Laboratories between April 1999 and May 2001.Results A total of 946 rabbits (670 NZW and 276 NZW × NZR) ranging in age from 77 to 288 days were examined. Of the NZW rabbits, 333 were males and 337 were females. Of the NZW × NZR (F1) rabbits, 139 were males and 137 were females. Thirty‐eight NZW rabbits (23 males and 15 females) exhibited immature cataracts in one or both eyes, and three NZW × NZR (F1) rabbits (one male and two females) exhibited cataracts in one or both eyes. The overall incidence of cataracts was 4.3% of all rabbits. Males and females were equally affected, but a significant difference in the incidence of cataracts existed between the NZW and NZW × NZR (F1) rabbits with 5.7% of the NZW rabbits affected and 1.1% of the NZW × NZR (F1) rabbits affected.Conclusion Spontaneous juvenile cataracts occur in rabbits and may develop as incidental lesions during toxicologic studies. The incidence of cataracts noted in our studies is consistent with an autosomal recessive mode of inheritance, but further studies are needed to confirm the mode or modes of inheritance. Hybrid pigmented rabbits (F1 or NZW × NZR) exhibited a significantly lower incidence of cataracts.
Hemangiosarcoma of the third eyelid in a cat
Authors: Multari Domenico , Vascellari Marta , Mutinelli Franco 
Published: March 2003

AbstractA case of hemangiosarcoma of the third eyelid in a 15‐year‐old Domestic Short‐haired cat is reported. A small red mass protruding from the anterior surface of the third eyelid in the left eye was present. Only mild bilateral conjunctivitis and nuclear sclerosis were revealed on initial ophthalmic examination. After anti‐inflammatory treatment, surgery and cryotherapy were performed. On histopathologic examination the mass was located just beneath the conjunctival epithelium, suggesting that the conjunctiva was the tissue of origin. The tumor showed high cellularity and was composed of pleomorphic spindle and polygonal cells arranged in interlacing bundles and solid sheets. The presence of slit‐like spaces between tumor cells containing erythrocytes demonstrated the vascular differentiation. Mitotic activity was moderate, but atypical mitoses were detected. The surgical area healed uneventfully and after 7 months there was no recurrence. To the authors’ knowledge, this is the first report of conjunctival hemangiosarcoma of the third eyelid in a cat.