anesthesia for appendicectomy in adolescent

OBJECTIVE: To investigate clinical benefits of warm, humidified carbon dioxide (CO(2)) insufflation for acute laparoscopic appendicectomy on postoperative pain and recovery in children (age 8-14 years). BACKGROUND: Conventional CO(2) insufflation leads to desiccation-related peritoneal inflammation and injury, which is preventable with warm, humidified CO2 gas. We hypothesized that reduced peritoneal desiccation would improve patient-centered outcomes in children after laparoscopic appendicectomy...

PURPOSE: To report injury patterns and management of musculoskeletal injuries after an earthquake. METHODS: 94 male and 161 female patients aged 17 to 90 (mean, 53) years underwent surgery for musculoskeletal injuries. Their injury patterns, anaesthesia administered, surgeries undertaken, and development of postoperative complications were reviewed. RESULTS: Of the 255 patients, 155 sustained superficial lacerations with minor soft-tissue contusion, whereas 100 sustained injuries that necessitated surgery under anaesthesia...

OBJECTIVE: This study sought to determine the efficacy of post-operative wound infiltration with local anaesthetic following paediatric appendicectomy. METHOD: In a randomised, controlled, prospective, clinical trial children aged between five and sixteen years were assigned to one of three treatment arms; infiltration of the surgical wound with bupivicaine, saline, or no infiltration. Anaesthetic and analgesic protocols were employed. Patients and observers were blinded to the treatment group...

The ProSeal laryngeal mask airway (PLMA) has been used routinely for anaesthesia and for difficult airway management including airway rescue in non-fasted patients. Compared with the classic laryngeal mask airway the PLMA increases protection against gastric inflation and pulmonary aspiration, by separating the respiratory and gastro-intestinal tracts. The PLMA has potential advantages over use of the tracheal tube including smoother recovery, reduced pharyngolaryngeal morbidity and even reduced postoperative pain...

BACKGROUND: Patients in whom extensive investigations have failed to identify the cause of abdominal pain present a challenge to surgeons. We present our initial experience of using laparoscopy under local anaesthetic and sedation in the diagnosis of chronic abdominal pain. METHODS AND PATIENTS: Nine patients with chronic abdominal pain and multiple normal investigations underwent laparoscopy under local anaesthetic and sedation. By touching and grasping intra-abdominal viscera and peritoneum, an attempt was made to reproduce the patient's pain...

OBJECTIVE: To determine on a national level the factors associated with the use of laparoscopy for digestive surgery. STUDY DESIGN: Nation wide study using a large representative sample (3 days of anaesthesia in France). METHODS: Univariate followed by multivariate analyses of data gathered in 1996 during the survey led by the French Society of Anaesthesia and Intensive care ("SFAR") including 2847 surgical procedures for cholecystectomy, appendicectomy or inguinal herniorraphy...

BACKGROUND: There are no epidemiological data describing tracheal intubation and laryngeal mask airway (LMATM) use in paediatric anaesthesia. This analysis focused on the factors leading to the indication for an airway management procedure, i.e. tracheal intubation and laryngeal mask airway vs face mask during general anaesthesia for tonsillectomy and appendicectomy. METHODS: The data were recorded in the French survey of Practical Anaesthesia performed in 1996...

Thirty-six young patients (12-17 years old) for appendicectomy were randomly allocated to receive ketamine 0.5 mg.kg-1 (K 0.5 group; n = 12), ketamine 1.0 mg.kg-1 (K 1.0 group; n = 12), or lactated Ringer's solution 5 ml (control group; n = 12), which was administered intravenously before incision. After the surgery, all patients received a nonsteroidal anti-inflammatory drug (NSAID) without limitation as requested by the patient. Pain scores at rest and on movement were assessed at 6-10 hr, 24 hr, and 48 hr post-operatively using a visual analogue scale...

BACKGROUND: The length of hospital stay following appendicectomy in children at Christchurch Hospital has decreased in recent years. The aim of the present study was to identify those factors that contributed to this change. METHODS: A retrospective review of children admitted to Christchurch Hospital between 1994 and 1998 inclusive who underwent appendicectomy for suspected appendicitis was conducted. Data recorded included standard demographic information, symptom duration, operative details, analgesia, antibiotics, pathology, complications and postoperative length of stay (LOS)...

BACKGROUND: Postoperative shoulder-tip pain (STP) frequently occurs following laparoscopic surgery. In an attempt to abrogate this complication we prospectively evaluated the efficacy of intraoperative irrigation of the diaphragm with bupivacaine. METHODS: One hundred and five consecutive patients undergoing laparoscopic surgery were prospectively randomized to treatment or control groups. Treatment group (B, n = 55) received irrigation with 10 mL 0.5% bupivacaine in 500 mL saline and control group (A, n = 50) received an equal volume of normal saline...

A postal questionnaire was sent to all members of the Northern Ireland Society of Anaesthetists to determine current practice in anaesthesia for children with acute appendicitis. Respondents were asked to describe their usual practice in such cases. They were also asked about the occurrence of complications due to the use of suxamethonium, and for their views on the use of rocuronium in such cases. Few major differences in anaesthetic technique were demonstrated. 74% of consultants and 84% of trainees always perform a rapid sequence induction for appendicectomy...

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The effects during surgery of a new halogenated volatile anaesthetic, isoflurane, on the hypothalamo-hypophyseal-thyroid-suprarenal axis were studied. In fact, it was important to prove whether this new halogenated anaesthetic would provide better protection, for the patient, from surgery and anaesthetic stress compared with other anaesthetic agents in use. The study was carried out in 16 young class ASA I patients who were to undergo appendicectomy. Before and during operation, blood was taken to measure ACTH, cortisol, TSH, T3, T4 and PRL plasma levels...