Functional magnetic resonance imaging (fMRI) in pediatric patients presents a unique set of problems due to the need for patient compliance, the frequent need for sedation and an early developmental status. A new method for using fMRI in sedated infants and young children is presented using passive stimuli focused on visual, sensorimotor and language functions. All of these stimuli are presented such that no patient interaction is required. Eight sedated children undergoing diagnostic MRI scans of the brain participated in these passive fMRI procedures. Cortical regions were identified using standard techniques applied to the blood-oxygen-level-dependent signal which is the basis for fMRI. The results support the feasibility of brain mapping in sedated children with passive fMRI techniques.
Nausea and vomiting .associated with chemotherapy are important deterrents to paediatric patients from complying with their chemotherapeutic protocols. ~ High-dose steroids, metoclopramide, dopamine D-2 receptor antagonists, and derivatives of cannabinoids are among the many drugs that are employed to address this problem. 2~ None has emerged as the drug of choice to treat chemotherapy-induced nausea and vomiting and thus this clinical dilemma remains unresolved. We have reported that following the introduction of propofol for induction of general anaesthesia in our paediatric oncology patients, the incidence of postoperative nausea and vomiting was reduced to less than 1%.5 This observation led us to speculate that propofol has intrinsic antiemetic properties. We report our preliminary experience with the use of propofol for the treatment and prophylaxis of chemotherapy-induced nausea and vomiting in three patients.
Case #1A 13-yr-old, 40 kg girl with osteogenic sarcoma of the humerus presented to our hospital after a night of intractable nausea and vomiting following high-dose metho-CAN J ANAESTH 1992 / 39:2 / pp 170-2
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