Assuntos
Doenças Cerebelares/induzido quimicamente , Doenças Cerebelares/terapia , Overdose de Drogas/terapia , Metadona/intoxicação , Insuficiência de Múltiplos Órgãos/induzido quimicamente , Insuficiência de Múltiplos Órgãos/terapia , Adolescente , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
In this randomized, double-blind trial we evaluated the quality and duration of analgesia and motor effects after caudal block using 1 mL/kg of ropivacaine 0.1% (Group 1), 0.15% (Group 2), 0.175% (Group 3) compared to 0.2% (Group 4) in infants 1-12 mo old. Postoperatively, the number of infants who received pain medication differed among the groups (P < 0.0005). There were more infants in Groups 1 and 2 compared with Group 4 and there was no difference between Groups 3 and 4. In the postanesthesia care unit, infants in Groups 1 and 2 received more pain medication than did those in Group 4 (P = 0.0098). In the day surgery unit, there was a significant difference among the groups (P = 0.0326); infants in Groups 3 and 4 required no pain medication. The analgesia duration differed among the groups (P = 0.034). Infants in Groups 1 and 2 had a shorter duration, and there was no difference between Groups 3 and 4. Infants in Group 4 took longer to regain their motor power compared with those in Group 3 (P = 0.0347). We conclude that in infants, ropivacaine 0.175% provided postoperative analgesia and duration similar to that of ropivacaine 0.2%, whereas ropivacaine 0.1% and 0.15% did not, and it was associated with fewer motor effects.
Assuntos
Amidas/administração & dosagem , Anestesia Caudal , Anestésicos Locais/administração & dosagem , Dor Pós-Operatória , Procedimentos Cirúrgicos Ambulatórios , Período de Recuperação da Anestesia , Anestesia Geral , Método Duplo-Cego , Humanos , Lactente , Masculino , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/tratamento farmacológico , RopivacainaRESUMO
Extracorporeal life support (ECLS) is used to support patients with pulmonary alveolar proteinosis (PAP) both during acute illness and during lung lavage therapies. We report the challenges encountered while providing ECLS for respiratory failure to a 12-year-old girl with PAP who had previously received ECLS as a toddler for a prior episode of respiratory failure due to PAP. She was placed on venovenous-arterial (VVA) ECLS and subsequently switched to venovenous (VV) ECLS with drainage from the right femoral vein and reinfusion by a long cannula placed into the right atrium. Our case illustrates standard cannulation may not be possible for children requiring a second ECLS course and the importance of considering alternative modes of cannulation and ECLS support when conventional methods are not possible.