Das ehemalige Frühgeborene mit Leistenhernien

Gerber, Andri; Weiß, Markus

doi:10.1007/s00101-002-0321-x

Cited by 32 publications

(5 citation statements)

References 79 publications

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“…Spinal anesthesia in children is characterized by a high success rate of more than 80% (2,6,(17)(18)(19). Nevertheless it represents a challenge even for the experienced anesthetist in ELBW infants because of the small anatomical structures.…”

Section: Discussionmentioning

confidence: 99%

Spinal anesthesia in an extremely low birth weight infant

Nickel¹,

Meyer²,

Brambrink³

2005

Pediatric Anesthesia

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A case of spinal anesthesia in an extremely low birth weight male infant (body weight of 930 g at time of surgery) is presented. He was born prematurely at a gestational age of 27 weeks because of a placenta tumor and had to undergo inguinal herniotomy at 34 weeks postconceptional age. He had bronchopulmonary dysplasia and oxygen supply was still required because of frequent deterioration of oxygen saturation. Spinal anesthesia was performed successfully without any complications. Relevant aspects concerning the technique and management of spinal anesthesia in preterm infants are discussed.

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Section: Discussionmentioning

confidence: 99%

Spinal anesthesia in an extremely low birth weight infant

Nickel¹,

Meyer²,

Brambrink³

2005

Pediatric Anesthesia

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“…In Bezug auf Besonderheiten der Wachkaudalanästhesie wird auf die Arbeiten von Gerber u. Weiss [14] sowie Hölzle et al [15] verwiesen.…”

Section: B)unclassified

62 Kaudalanästhesie bei Kindern

Genzwürker¹,

Hinkebein²

2007

Fallbuch Anästhesie, Intensivmedizin Und Notfallmedizin

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Caudal block is a safe procedure commonly used for pediatric perioperative analgesia. Complications are extremely rare but nevertheless local and systemic contraindications must be excluded. Optimal safety and quality result when strict attention is paid to technical details. A local anesthetic (LA) containing epinephrine allows early detection of inadvertent intravascular LA administration; therefore an epinephrine/LA mixture is recommended at least for the test dose. In terms of safety the choice of LA itself is probably of secondary importance. Clonidine as an adjuvant has an excellent risk/benefit profile with minimal side effects. Inadvertent systemic LA intoxication is a rare but potentially fatal complication of regional anesthesia and measures for prevention and early detection are essential. Should circulatory arrest occur, immediate resuscitation following standard guidelines is to be initiated including the use of epinephrine as the first line drug. Intravenous administration of lipid solutions may be beneficial as a secondary adjunct to stabilize hemodynamics but is not an alternative to epinephrine. ZertifizierungDiese Fortbildungseinheit ist mit 3 CMEPunkten zertifiziert von der Landesärzte-kammer Hessen und der Nord rheinischen Akademie für Ärztliche Fort-und Weiterbildung und damit auch für andere Ärzte-kammern anerkennungsfähig. Hinweis für Leser aus ÖsterreichGemäß dem Diplom-Fortbildungs-Programm (DFP) der Österreichischen Ärzte-kammer werden die in der e.Akademie erworbenen CME-Punkte hierfür 1:1 als fachspezifische Fortbildung anerkannt. Caudal block is a safe procedure commonly used for pediatric perioperative analgesia. Complications are extremely rare but nevertheless local and systemic contraindications must be excluded. Optimal safety and quality result when strict attention is paid to technical details. A local anesthetic (LA) containing epinephrine allows early detection of inadvertent intravascular LA administration; therefore an epinephrine/LA mixture is recommended at least for the test dose. In terms of safety the choice of LA itself is probably of secondary importance. Clonidine as an adjuvant has an excellent risk/benefit profile with minimal side effects. Inadvertent systemic LA intoxication is a rare but potentially fatal complication of regional anesthesia and measures for prevention and early detection are essential. Should circulatory arrest occur, immediate resuscitation following standard guidelines is to be initiated including the use of epinephrine as the first line drug. Intravenous administration of lipid solutions may be beneficial as a secondary adjunct to stabilize hemodynamics but is not an alternative to epinephrine. Kontakt und weitere InformationenSchmerz 2012 · 26:443-454 DOI 10.1007/s00482-012-1202-0 © Deutsche Schmerzgesellschaft e.V. Published by Springer-Verlagall rights reserved Keywords

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“…Besonders sensitiv reagieren hierbei ehemalige Frühgeborene. So beschreiben Gerber u. Weiss bei diesem Patientenkollektiv mit 1,2 ml/kg 0,25%igem Bupivacain motorische Blockaden von bis zu 2 h [33].…”

Section: "Klassische" Lokalanästhetika Bupivacainunclassified

Kaudalanästhesie

2003

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Caudal anaesthesia is the most frequently used regional technique in paediatric anaesthesia. Caudal in combination with general anaesthesia is usually performed in healthy children (i.e. for herniotomy or hypospadias). Therefore every complication of this method is a catastrophe, even when the incidence of these complications is very low. Some of the documented complications of caudal anaesthesia in children are caused by the local anaesthetic solutions and/or by additives. Thus, the choice of substances for paediatric caudal blocks should minimize the risk associated with the substances used for this indication. Over the last decades the standard was bupivacaine but because of serious cardiovascular and central-nervous toxicity following inadvertent intravascular injection of bupivacaine during caudal puncture, the less toxic ropivacaine should be favoured for this indication. A huge number of clinical studies have proven the clinical effectiveness and safety of ropivacaine also for this indication. In addition, levobupivacaine, the L-enantiomere of bupivacaine, will also be an interesting local anaesthetic in the future for paediatric caudal anaesthesia. By using additives to local anaesthetics better analgesic properties should be obtained. Following an exact review of the literature, only clonidine and S(+)-ketamine are useful additives to local anaesthetics in paediatric caudal anaesthesia.

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Das ehemalige Frühgeborene mit Leistenhernien

Cited by 32 publications

References 79 publications

Spinal anesthesia in an extremely low birth weight infant

Spinal anesthesia in an extremely low birth weight infant

62 Kaudalanästhesie bei Kindern

Kaudalanästhesie

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