Intravenous Dezocine for Postoperative Pain: A Double‐Blind, Placebo‐Controlled Comparison With Morphine

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97255/1/j.1552-4604.1986.tb03523.x.pd

The Hague: 10th World Congress of Anaesthesiologists: Panel on ambulatory care

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30917/1/0000587.pd

Regional anaesthesia for outpatient surgery

Regional anaesthesia is an ideal anaesthetic technique for many outpatient surgery procedures. With proper preparation, selection and planning, regional anaesthesia will provide excellent operating conditions for the surgeon and a very satisfactory anaesthetic state for the patient in a cost-effective way. Its minimum effect on major organ functions, intense sensory blockade, low potential for postoperative side effects, and its ability to provide postoperative pain control, offers an excellent set up for these patients who will go home soon after the surgery.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31894/1/0000846.pd

Dolasetron for the prevention of postoperative vomiting in children undergoing strabismus surgery

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72128/1/j.1460-9592.2003.01076.x.pd

Pneumocephalus after posterior fossa exploration in the sitting position

Entrainment of air following exploration of posterior cranial fossa in the sitting position was studied in five patients. Intracranial pressure was monitored through a ventriculostomy catheter after closure of the dura. In three patients nitrous oxide was added to the breathing mixture only after the baseline intracranial pressure had stabilised following closure of the dura. A marked rise in intracranial pressure was observed immediately. A rapid decrease in intracranial pressure occurred when nitrous oxide administration was stopped. Two patients were given nitrous oxide from the beginning. No change in intracranial pressure was noted. Computerised tomogram on the first postoperative day revealed a significant amount of air in eight cases.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72920/1/j.1365-2044.1982.tb01711.x.pd

Upper respiratory tract infections and general anaesthesia in children

Conflicting reports regarding the hazards of anaesthesia in children presenting for surgery with an upper respiratory tract infection have appeared in the literature. In the present study 130 children undergoing general anaesthesia with face mask for myringotomy and grommet insertion were graded as having either an acute or recent upper respiratory tract infection or were asymptomatic according to predetermined clinical symptoms and signs. The severity of respiratory and related complications were scored during induction, emergence and recovery. The peripheral oxygen saturation was recorded during induction, emergence, transfer to the recovery ward and in the recovery ward itself. There were no significant differences (p > 0.05) in the complication scores between the three groups of children. However, the incidence of hypoxaemia (oxygen saturation ± 93%) was significantly greater during transfer in the acute infection group (p = 0.001) and the recent infection group (p = 0.02), as well as during recovery in the acute group (p = 0.03) compared with asymptomatic children.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75689/1/j.1365-2044.1992.tb02389.x.pd

Induction and recovery characteristics of isoflurane and halothane anaesthesia for short outpatient operations in children

Induction and recovery characteristics of isoflurane anaesthesia were compared with halothane anaesthesia during outpatient myringotomy and placement of Sheely ventilation tubes in 101 unpremedicated children. Compared with halothane, isoflurane resulted in prolonged induction times and inferior induction scores due to increased salivation, coughing, breathholding and laryngospasm. However, when modified by halothane induction, isoflurane anaesthesia decreased induction time and improved induction scores. Induction with thiamylal 4 mg/kg did not improve induction scores significantly. Recovery times from halothane plus isoflurane and pure isoflurane anaesthesia were quicker than pure halothane and thiamylal plus isoflurane, although this was not statistically significant. Compared to halothane, anaesthetic induction using isoflurane is associated with an increased incidence of respiratory problems in unpremedicated children.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75280/1/j.1365-2044.1985.tb10665.x.pd

Risk factors for adverse postoperative outcomes in children presenting for cardiac surgery with upper respiratory tract infections. Anesthesiology.

Background: Otherwise healthy children who present for elective surgery with an upper respiratory infection (URI) may be at risk for perioperative respiratory complications. This risk may be increased in children with congenital heart disease who undergo cardiac surgery while harboring a URI because of their compromised cardiopulmonary status. Therefore, this study was designed to determine the incidence of peri-and postoperative complications in children undergoing cardiac surgery while harboring a URI. Methods: The study population consisted of 713 children scheduled to undergo cardiac surgery. Of these, 96 had symptoms of URI, and 617 were asymptomatic. Children were followed prospectively from induction of anesthesia to discharge from the hospital to determine the incidence of postoperative respiratory, cardiovascular, neurologic, and surgical adverse events. Duration of postoperative ventilation, time in the intensive care unit (ICU), and length of hospital stay were also recorded. Results: Children with URIs had a significantly higher incidence of respiratory and multiple postoperative complications than children with no URIs (29.2 vs. 17.3% and 25 vs. 10.3%, respectively; P < 0.01) and a higher incidence of postoperative bacterial infections (5.2 vs. 1.0%; P ‫؍‬ 0.01). Furthermore, logistic regression indicated that the presence of a URI was an independent risk factor for multiple postoperative complications and postoperative infections in children undergoing open heart surgery. Children with URIs also stayed longer in the intensive care unit than children with no URIs (75.9 ؎ 89.8 h vs. 57.7 ؎ 63.8, respectively; P < 0.01). However, the overall length of hospital stay was not significantly different (8.4 vs. 7.8 days, URI vs. non-URI groups; P > 0.05). Conclusions: The presence of a URI was predictive of postoperative infection and multiple complications in children presenting for cardiac surgery. Despite this, the presence of a URI does not appear to affect the patient's overall length of hospital stay nor the development of long-term sequelae