Vecuronium infusion requirements in paediatric patients in intensive care units: the use of acceleromyography.

Neuromuscular blocking drugs in intensive care units (ICU) may cause complications, including prolonged neuromuscular block as a result of overdosage and post-ventilation muscle weakness. These may be increased by using inappropriately high infusion rates for infants, in whom published studies are scarce, and by failure to monitor neuromuscular block. There is little ICU experience of acceleromyography, which may permit more reliable monitoring.

Filtration of fentanyl is not the cause of the elevation of arterial blood pressure associated with post-bypass ultrafiltration in children.

Modified ultrafiltration after cardiopulmonary bypass in children has been shown to be associated with an increase in arterial blood pressure. As part of a series of studies to investigate the possible causes of this blood pressure elevation, the hypothesis that if filtration was removing a significant amount of fentanyl, then the increase in blood pressure might be due to pain was proposed. Ten children, aged between 0.

Tracheal intubation in a mannikin: comparison of the Belscope with the Macintosh laryngoscope.

Tracheal intubation carries a risk of accidental oesophageal intubation; this is increased with inexperienced trainees, and in patients with a difficult airway. The recent introduction of an angulated laryngoscope, the Belscope, may permit a better view of the vocal cords and increase the accuracy of orotracheal intubation. To determine how easy it is to learn to use the Belscope compared with the traditional Macintosh laryngoscope, a group of medical students attempted to intubate a mannikin which had been modified to simulate a difficult intubation.

Anaesthesia for airway obstruction in laryngo-onycho-cutaneous syndrome.

A 4-year-old boy with laryngo-onycho-cutaneous syndrome underwent excision of an obstructive vocal cord lesion. There is only one previous case report of laryngeal involvement in this syndrome but the anaesthetic management has not been reported. The anaesthetic management for microlaryngobronchoscopy and laser surgery in this child with upper airway obstruction is described.