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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Anaesthesist 45 (1996), S. 420-427 
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Anästhesie im Kindesalter ; Nahrungskarenz ; Aspirationsrisiko ; Key words Anaesthesia ; Children ; Fasting ; Aspiration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract According to a literature search, it seems most unlikely based on pathophysiological requirements and physiological aspects that traumatized children benefit from preoperative waiting times aimed at achieving a 6-h fast. Irrespective of fasting, traumatized children are at risk of requiring aspiration. Many generally recommended measures for the avoidance of aspiration are neither reasonable nor effective in traumatized children. The physical and psychological benefits that can be derived from shorter preoperative waiting times can more than override the organizational difficulties caused by waiting longer.
    Notes: Zusammenfassung Die pathophysiologischen Bedingungen nach Trauma sowie die physiologischen Verhältnisse im Kindesalter lassen es anhand einer Literaturrecherche (s.a. Tabelle 4) als sehr unwahrscheinlich erscheinen, daß Kinder von einer präoperativen Wartezeit zur Erzielung einer 6stündigen Nahrungskarenz profitieren. Traumatisierte Kinder sind unabhängig von der Nahrungskarenz aspirationsgefährdet. Viele allgemein empfohlene Maßnahmen zur Aspirationsverhütung sind bei Traumata im Kindesalter nicht sinnvoll und effektiv. Die durch eine verkürzte präoperative Wartezeit erzielbaren physischen und psychischen Benefits dürften die dadurch bedingten organisatorischen Erschwernisse mehr als aufwiegen.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Pediatric anesthesia 5 (1995), S. 0 
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Twenty ASA 1 children, one to six years old, weighing 10–20 kg, scheduled for a combination of general and caudal anaesthesia received at random midazolam 0.2, 0.4, or 0.6 mg·kg−1 or NaCl 0.9% (control group) intranasally. Drug or NaCl 0.9% were administered in one nostril, after inhalation induction of anaesthesia, intubation without relaxant and caudal anaesthesia. Spontaneous respiration was via a circle system and fresh gas flow of 61·min−1 (N2O/O2= 2:1), PEEP 5 cm H2O, endtidal halothane 0.4%.Immediately before and 2, 5, 8, 12, 16, 20, 30, 60 and 120 min after application of the drug 2.5 ml blood was sampled for plasma levels of midazolam. Endtidal CO2, respiratory rate, and oxygen saturation were recorded as long as the children were intubated. Endtidal CO2 and respiratory rate showed no statistical difference between the groups at any time, however, in the group receiving 0.6 mg·kg−1, -endtidal CO2 increased significantly from 5.3 kPa (41 mm Hg) at the start to 5.9 kPa (45.5 mm Hg) after 30 min. Plasma levels of midazolam were detected 2 min after application in 10 of 15 patients. Median peak levels were found between 12 and 16 min. Medians of peak plasma levels showed no statistical difference between the three groups (0.2 mg·kg−1:111 ng·ml−1, 0.4 mg·kg−1:136 ng·ml−1, 0.6 mg·kg−1:277 ng·ml−1). After 30, 60 and 120 min medians of midazolam plasma concentration were significantly higher in the group 0.6 mg·kg−1.
    Type of Medium: Electronic Resource
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