Thames Deanery - St-marys-anaesthesia.co.uk

Thames Deanery 

Trainers in 

Paediatric 

Anaesthesia 

Group 

ThamesPAG@gosh.nhs.uk 

Resource and 

Information Pack 

3rd edition 

© GOSH / Thames PAG, Drs R Howard & I Walker, 3 rd edition, May 2002 1

First Edition published 1997 

Second Edition Nov 2000 

Third Edition May 2002 

Editors 

Dr Richard Howard 

Dr Isabeau Walker 

Great Ormond Street Hospital for Children NHS Trust 

© Thames Deanery: Trainers in Paediatric Anaesthesia Group 

All rights reserved. This publication may not be reproduced, stored 

in a retrieval system nor transmitted in any form or by any means, 

electronic, mechanical, photocopying, recording or otherwise, 

without the prior written permission of the copyright holders. 

Whilst every care has been taken to ensure that doses and 

recommendations are correct, the responsibility for final 

checking must rest with the prescriber. The authors cannot 

accept any responsibility for errors in this publication. 


Resource Information Pack 

Thames Trainers in Paediatric Anaesthesia 

List of Lead Clinicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6 

Training recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 

Training policy p Supervision . . . . . . . . . . . . . . . . . . . . 8 

p Resuscitation . . . . . . . . . . . . . . . . . . . . 8 

c 

o 

n 

t 

e 

n 

t 

s 

Emergency Resuscitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 

Fasting policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 

Preoperative upper respiratory tract infections . . . . . . . . . . . . . . 11 

Endocarditis prophylaxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 

Incidental heart murmurs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 

Pain management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 

Local anaesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 

Analgesics & anti-emetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 

Fluid balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 

Acute major anaphylaxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 

Malignant hyperthermia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 

Latex allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 

Sickle Cell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21-22 

Reading materials p Textbooks . . . . . . . . . . . . 23 

p Journals . . . . . . . . . . . . 24 

p Useful publications . . . . . . . . . . . . 25 

p Internet resources . . . . . . . . . . . . 26-28 

p Key references . . . . . . . . . . . . 29-30 

Journal Club p premedication, general anaesthesia, ENT 31-42 

& eyes, dental surgery, pain & analgesia, 

day-care, sedation, resuscitation, 

miscellaneous, organisation 


Group Co-ordinators 


Dr Richard Howard 

GOSH for Children 

NHS Trust 

Great Ormond St 

London WC1N 3JH 

Lead Clinicians 

Thames Paediatric Trainers 

020 7829 

8865 ThamesPAG 

@gosh.nhs.uk 

hospital name address phone email 

Barnet General 

Hospital 

Barnet General 

Hospital 

Dr Regina 

Milaszkiewicz 

Dr Iris Symons 

Wellhouse Lane 

Barnet 

Herts EN5 3DJ 

Wellhouse Lane 

Barnet 

Herts EN5 3DJ 

Basildon Hospital Dr Helen Utting Nethermayne 

Basildon 

Essex SS16 5NL 

Bromley Hospital Dr Pauline Vine Cromwell Avenue 

Bromley 

Kent BR2 9AJ 

Broomfield Hospital Dr Kevin Kiff Broomfield 

Chelmsford 

Essex CM1 7ET 

Broomfield Hospital Dr M Davis Broomfield 

Chelmsford 

Essex CM1 7ET 

Chase Farm Hospital Dr David Harvey The Ridgeway 

Enfield 

Middlesex EN2 8JL 

Chase Farm Hospital Dr Stelios Pavlou The Ridgeway 

Enfield 

Chelsea & 

Westminster Hospital 

Dr Nick Fauvel 

Middlesex EN2 8JL 

369 Fulham Road 

London SW10 9TH 

020 8216 

4000 

020 8216 

4000 

01268 533911 

020 8289 

7000 

regina.milaszkiewicz 

@barnet-chasetr.nhs.uk 

Iris.symons 

@barnet-chasetr.nhs.uk 

Pauline.Vine 

@bromleyhospitals 

.nhs.uk 

01245 440761 Kevin_Kiff 

@hotmail.com 

01245 440761 martin.e.davis 

@btinternet.com 

020 8366 

6600 

020 8366 

6600 

020 8746 

8000 

david @harvey- 

1gas.demon.co.uk 

drsppavlou 


Chelsea & 

Westminster Hospital 

Dr Mike Weston 

369 Fulham Road 

London SW10 9TH 

020 8746 

8000 

HKP@psilink.co.uk 

Colchester General 

Hospital 

Epsom General 

Hospital 

Great Ormond Street 

Hospital for Children 

Dr Gerald Timmins 

Dr Anna-Maria Rollin 


Turner Road 

Colchester 

Essex CO4 5JL 

Dorking Road 

Epsom 

Surrey KT18 7EG 

Great Ormond St 

London WC1N 3JH 

01206 853535 timmins1 

@tesco.net 

01372 735735 arollin@sthelier. 

sghms.ac.uk 

020 7829 

8865 

WalkeI 

@gosh.nhs.uk 

Guys Hospital Dr Claire Shannon St Thomas Street 

London SE1 9RT 

Hammersmith 

Hospital 

Dr David Zideman 

Du Cane Road 

East Acton 

London W12 0HS 

Hillingdon Hospital Dr Jan Downer Pield Heath Road 

Uxbridge 

Middlesex UB8 3NN 

020 7955 

5000 

020 8846 

1234 

claire.shannon 

@gstt.sthames.nhs. 

uk 

01895 238282 jan.downer 

@thh.nhs.uk 

Kings College Dr Cathie Hill Denmark Hill 020 737 4000 catherine.hill 


Hospital London SE5 9RS @kingshc.nhs.uk 



Thames Paediatric Trainers (cont) 


Kingston Hospital Dr Richard Stacey Galsworthy Road 

Kingston upon 

Thames 

Surrey KT2 7QB 

Kingston Hospital Dr Carol Stableforth Galsworthy Road 

Kingston upon 

Thames 

Surrey KT2 7QB 

Lewisham Hospital Dr Richard Arnold High St 

Lewisham 

London SE13 

Lister Hospital Dr Pin Patel Coreys Mill Lane 

Stevenage 

Herts SG1 4AB 

Lister Hospital Dr Prasun Sengupta Coreys Mill Lane 

Stevenage 

Mayday University 

Hospital 

Moorfields Eye 

Hospital 

Mount Vernon 

Hospital 

Mount Vernon 

Hospital 

Northwick Park 

Hospital 

Northwick Park 

Hospital 

Dr Kim Hughes 

Dr Jonathan Lord 

Dr Julie Forsyth 

Dr A Hayward 

Dr Pradeep Kulkarni 

Dr Roger Sharpe 

Herts SG1 4AB 

London Road 

Croyden 

Surrey CR7 7YE 

City Road 

London EC1V 2PD 

Rickmansworth Rd 

Northwood 

Middlesex HA6 2RN 

Rickmansworth Rd 

Northwood 

Middlesex HA6 2RN 

Watford Road 

Harrow 

Middlesex HA1 3UJ 

Watford Road 

Harrow 

Middlesex HA1 3UJ 

Oldchurch Hospital Dr Joanne Umo-Etuk Romford 

Essex RM7 0BE 

020 8546 

7711 

020 8546 

7711 

020 8690 

4311 

01438 314333 

01438 314333 

020 8401 

3000 

020 7253 

3411 

carol.stableforth 

@kh-tr.sthames. 

nhs.uk 

richard@richardarnold.co.uk 

rheron 

@globalnet.co.uk 

Jonathan.lord 

@moorfields.nhs.u 

k 

01923 826111 drjuliebinns 


01923 826111 

020 8864 

3232 

020 8869 

3974 

020 8864 

3232 

020 8869 

KULPRAD@aol.co 

rsharpe065 

@aol.com 

3974 

01708 708443 JoanneCoker 


Princess Alexandra 

Hospital NHS Trust 

Queen Elizabeth 

Hospital 

Dr Zdenek Zych 

Dr Sharon Power 

Hamstel Road 

Harlow 

Essex CM20 1QX 

Woolwich 

London SE18 4QH 

01279 444455 

020 8836 

6000 

Queen Marys 

Hospital 

Royal Brompton and 

Harefield 

Dr Punitha Ganeshan Frognal Avenue 

Sidcup 

Kent DA14 6LT 

Dr Andrea Kelleher Sydney St 

London SW3 

020 8302 

2678 

MSGanesh 


a.kelleher 

@rbh.nthames.nhs.uk 

Royal Free Hospital Dr Shelagh Charlton Pond Street 

Hampstead 

020 7794 

0500 


London NW3 2QG 

Royal Hospitals Trust Dr Anil Visram Whitechapel Road 

Whitechapel 

London E1 1BB 

020 7377 

7000 

avisram 

@compuserve.com 



Thames Paediatric Trainers (cont) 


Royal Hospitals Trust Dr Jo Challands Whitechapel Road 

Whitechapel 

London E1 1BB 

Royal Hospitals Trust Dr Lionel Davis Whitechapel Road 

Whitechapel 

London E1 1BB 

Royal Hospitals Trust Dr Alistair Marshall Whitechapel Road 

Whitechapel 

London E1 1BB 

Royal Hospitals Trust Dr Eddie McAteer Whitechapel Road 

Whitechapel 

London E1 1BB 

Southend Hospital Dr John Kinnear Prittlewell Chase 

Westcliff-on-Sea 

Essex SS0 0RY 

St Andrew's Centre 

for Plastic Surgery 

Burns 

St Georges Hospital 

Dr Ian Seggie 

Dr Darryl Hampson- 

Evans 

Court Road 

Broomfield 

Chelmsford CM12 

0BH 

Blackshaw Road 

Tooting 

London SW17 0QT 

St Georges Hospital Dr Linda Murdoch Blackshaw Road 

Tooting 

London SW17 0QT 

St Helier Hospital Dr Simon Hawkins Wrythe Lane 

Carshalton 

Surrey SM5 1AA 

St Helier Hospital Dr Sally Renwick Wrythe Lane 

Carshalton 

Surrey SM5 1AA 

St Mary's Hospital Dr Sanjay Gautama Praed Street 

Paddington 

London W2 1NY 

St Mary's Hospital Dr Mark Sacks Praed Street 

Paddington 

London W2 1NY 

St Mary's Hospital Dr Virin Sidhu Praed Street 

Paddington 

London W2 1NY 

St Thomas Hospital Dr Chris Aps Lambeth Road 

London SE1 7EH 

UCLH Hospitals Dr Jane Lockie Mortimer Street 

London W1N 8AA 

020 7377 

7000 

020 7377 

7000 

020 7377 

7000 

020 7377 

7000 

joanne.challands 

@bartsandthelondon 


lionel.sarah 

@tinyworld.co.uk 

maeogmarsh 


maeogmarsh 


01702 435555 jakinnear 

@doctors.org.uk 

01268 533911 

020 8672 

1255 

020 8672 

1255 

020 8296 

2000 

020 8296 

2000 

020 7725 

6666 

020 7725 

6666 

020 7725 

6666 

020 7928 

9292 

020 7636 

8333 

hampsonevans 


linda.murdoch 

@stgeorges.nhs.uk 

milesandsally 

@btopenworld.com 

sanjay.gautama 

@st-marys.nhs.uk 

marksacks 

@btinternet.com 

Chris.Aps 

@gstt.sthames 


jane.lockie 

@uclh.org 

UCLH Hospitals Dr Ann McAra Mortimer Street 

London W1N 8AA 

Whipps Cross 

Hospital 

Dr H Youssef 

Whipps Cross Road 

Leytonstone 

London E11 1NR 

Whittington Hospital Dr Catherine Shaw Highgate Hill 

Highgate 

020 7636 

8333 

020 8539 

5522 

020 7272 

3070 

a.mcara@uclh.org 

Ahmosy 

@aol.com.uk 

catherineshaw 

@whittington. 

nhs.com 


London N19 5NF 


Training recommendations 

for Thames SpRs in Paediatric Anaesthesia 

1. Three month 

module 

2. Training 

extension 

3. Further 

paediatric 

training 

p All trainees should complete a module of up to three 

months in paediatric anaesthesia, or its equivalent, 

during their SpR training programme. 

p The opportunity should be available to some trainees to 

extend this to 6 months in order to fulfil the 

recommendations for training as a consultant with an 

interest in paediatric anaesthesia. 

p The opportunity should be available for selected trainees 

to undertake further paediatric training for a minimum of 

one year in order to fulfil the recommended criteria for 

training as a full time paediatric anaesthetist. Some of 

this training could be overseas. 

4. Log book p Trainees should keep a log book of paediatric cases or 

be able to easily provide a summary of paediatric cases 

from their general log book. 

5. Common 

agreed 

policies 

p As far as is practical, hospitals in Thames Deanery 

where paediatric training takes place or children are 

anaesthetised, have common agreed policies on the 

basics of paediatric anaesthetic practice. 

Notes 

1. The RCA recommends that individuals appointed to a District General Hospital 

with a subspeciality interest in paediatric anaesthesia should have obtained at 

least six months or equivalent of full-time specialist training in paediatric 

anaesthesia in a specialist paediatric unit. 

2. They recommend that consultants with a substantial commitment to paediatric 

anaesthesia, including full-time paediatric anaesthetists working in specialist 

paediatric units need to have obtained at least one year or equivalent of fulltime 

specialist training in a specialist unit. This will be started in years 3-5 of 

the SpR training programme. 


Training policies 

Supervision 

• Each hospital has its own department of anaesthesia policy regarding the 

consultation of senior staff before anaesthesia in children. Trainees should not 

hesitate to seek advice in any instance of uncertainty. 

The RCA recommends: 

• ‘All children should be anaesthetised by a consultant or other career-grade 

anaesthetist who has regular relevant paediatric practice, or a trainee supervised 

by someone in the preceding categories. Supervision will vary according to the 

ability and experience of the trainee and the nature of the case. For example, an 

SHO with less than six months experience requires direct supervision in theatre or 

in the theatre suite, whilst an experienced SpR who has undergone a recent period 

of paediatric anaesthetic higher specialist training might be supervised by a 

consultant outside the hospital suite’. 

Resuscitation 

* Info at: www.resus.org.uk 

1. All trainees should be able to perform appropriate resuscitation on children. 

2. Each hospital where children are anaesthetised should provide resuscitation 

training. 

3. All trainees should be encouraged to attend a PALS or other suitable 

resuscitation training course.* 

4. All trainees who are interested in a career in paediatric anaesthesia should 

complete a PALS, APLS or other suitable resuscitation training course. 


Paediatric Emergency Chart 

Age Weight Length 

ET Tube 

Diameter 

ET Tube 

Length 

First dose of 

Epinephrine 

Atropine 

100 mcg/ml 

Bicarbonate* 

4.2% * 

Calcium 

Chloride 10% 

Lignocaine 

1% 

Amiodarone 

(50 th centile) crown/heel 

(50 th centile) 

uncuffed (oral) 1:10,000 

100 mcg/ml) 

(500 mcg amp 

in 5 ml water) 

0.5 mmol/ml 10 mg/ml (300 mg/10ml) 

dilute + flush 

with 5% glucose 

Newborn 3.5 kg 50 cms 3.0 ID mm 9 cm 30 mcg/0.3 ml 100 mcg/1.0 ml 3.5 mmol/7.0 ml 0.7 ml 0.35 ml 17.5 mg/0.58 ml 

1 month 4.0 kg 53 cms 3.0 ID mm 9 cm 40 mcg/0.4 ml 100 mcg/1.0 ml 4.0 mmol/8.0 ml 0.8 ml 0.4 ml 20 mg/0.66 ml 

3 months 5.0 kg 60 cms 3.0-3.5 ID mm 10 cm 50 mcg/0.5 ml 100 mcg/1.0 ml 5.0 mmol/10 ml 1.0 ml 0.5 ml 25 mg/0.83 ml 

Bicarbonate 

* 8.4% * 

1.0 mmol/ml 

6 months 7.0 kg 66 cms 3.5 ID mm 11 cm 70 mcg/0.7 ml 140 mcg/1.4 ml 7.0 mmol/7.0 ml 1.4 ml 0.7 ml 35 mg/1.16 ml 

1 year 10 kg 75 cms 4.0 ID mm 12 cm 100 mcg/1.0 ml 200 mcg/2.0 ml 10 mmol/10 ml 2.0 ml 1.0 ml 50 mg/1.66 ml 

2 years 12 kg 85 cms 4.5 ID mm 13 cm 120 mcg/1.2 ml 240 mcg/2.4 ml 12 mmol/12 ml 2.4 ml 1.2 ml 60 mg/2 ml 

3 years 14 kg 93 cms 4.5-5.0 ID mm 13-14 cm 140 mcg/1.4 ml 280 mcg/2.8 ml 14 mmol/14 ml 2.8 ml 1.4 ml 70 mg/2.33 ml 

4 years 16 kg 100 cms 5.0 ID mm 14 cm 160 mcg/1.6 ml 320 mcg/3.2 ml 16 mmol/16 ml 3.2 ml 1.6 ml 80 mg/2.66 ml 

5 years 18 kg 108 cms 5.0-5.5 ID mm 14-15 cm 180 mcg/1.8 ml 360 mcg/3.6 ml 18 mmol/18 ml 3.6 ml 1.8 ml 90 mg/3 ml 

6 years 20 kg 115 cms 5.5 ID mm 15 cm 200 mcg/2.0 ml 400 mcg/4.0 ml 20 mmol/20 ml 4.0 ml 2.0 ml 100 mg/3.33 ml 

8 years 25 kg 125 cms 6.0-6.5 ID mm 16 cm 250 mcg/2.5 ml 500 mcg/5.0 ml 25 mmol/25 ml 5.0 ml 2.5 ml 125 mg/4.16 ml 

10 years 34 kg 140 cms 7.0 (cuffed) 

ID mm 

17 cm 340 mcg/3.4 ml 500 mcg/5.0 ml 34 mmol/34 ml 7.0 ml 3.5 ml 170 mg/5.66 ml 

Epinephrine may be given endotracheally in 10x the initial 

intravenous dose 

(NB: more concentrated solutions may be required) 

OTHER DOSES 

Epinephrine During CPR a dose 10x the initial one may be considered especially 

if sepsis or anaphylaxis were primary causes of arrest 

Glucose 500 mg -1 g/kg (5-10 ml/kg 10%) 

Fluid bolus 0.9% saline or colloid: 20 ml/kg (repeat depending on response) 

Defibrillation 1 st series = 2 J/kg, 2 J/kg, 4 J/kg. All subsequent series are at 4 J/kg 


Fasting 

for general anaesthesia 

• Children over 1 year 

p No food or milk for 6 hours prior to anaesthesia 

p Clear fluids may be given up to 2 hours before anaesthesia 

• Babies under 1 year on regular milk feeds 

p No formula milk feeds for 6 hours prior to anaesthesia 

p No breast milk for 4 hours prior to anaesthesia 

p Clear fluids may be given up to 2 hours before anaesthesia 

p 

Babies having 2 hourly milk feeds - please discuss with the anaesthetist 


Preoperative upper respiratory tract infections 

suggested management for general anaesthesia 

• General anaesthesia in the presence of acute or recent URTI has been 

associated with: - hypoxaemia 

- laryngospasm 

- bronchospasm 

- death 

• Overall, the risk of adverse respiratory events increased by 2 - 7 times 

• Risk is increased by 10 times if endotracheal intubation is employed 

A. Children with URTI: ie. p Fever > 38 0 C 

p Mucopurulent nasal secretions 

p Lower respiratory symptoms/signs 

p Elevated WCC etc 

• Postpone surgery for 2 - 4 weeks 

B. Children with MILD URTI: ie. p Not unwell 

p Clear nasal discharge 

p Clear chest 

Age < 1 year 

Age 1 - 5 years 

Age > 5 years 

• Postpone surgery for 2 - 4 weeks 

• Consider risk / benefit ratio on 

an individual basis 

• At low risk 


Endocarditis prophylaxis 

• At risk patients 

All patients with structural cardiac defects 

whether repaired or not, are at risk. 

Exceptions p suture repair of ASD 

p ligation of PDA 

• Procedures 

All surgery or diagnostic procedures 

where bacteraemia is a significant risk, 

including all instrumentation or incisions 

involving mucous membrane lined tracts, 

and any surgery involving infected areas. 

Exceptions p tracheal intubation 

p flexible bronchoscopy 


suggested management of 

Incidental heart murmurs 

• Protocol for patients found to have a murmur prior to elective surgery 

The vast majority of children found to have a murmur pre-operatively have an innocent murmur. 

These innocent murmurs are characterised by being soft, early systolic murmurs with no thrill or 

abnormal cardiac impulses and are not associated with cardiac signs or symptoms. If a child is 

found to have a murmur prior to elective surgery a history and cardiac examination should be 

performed and an ECG done. 

• In the presence of a murmur an 

echocardiogram and cardiac opinion 

is indicated prior to surgery if: 

1. 

2. 

3. 

4. 

The child is younger than a year 

The murmur fits pathological criteria 

There are cardiac signs or symptoms 

Evidence of LVH or RVH 

(see following tables) 

• Criteria for pathological murmurs 

1. All diastolic murmurs 

2. All pansystolic 

3. Late systolic 

4. Very loud murmurs 

5. Continuous murmurs 

(other than a venous hum) 

6. Associated with cardiac signs or symptoms 

Diagnostic Tables (Davignan et al, 1979) 

Right ventricular hypertrophy 

1 - 5 years 5 - 12 years 

R wave amplitude in V1 > 1.75 mV > 1.25 mV 

R/S ratio in V1 > 3 > 2 

Also an upright T wave in V1 is a sign of right ventricular hypertrophy in the first 5 years of life 

Left ventricular hypertrophy 

1 - 5 years 5 - 12 years 

RV6 + SV1 > 4.0 mV > 4.55 mV 

RV5 > 3.5 mV > 3.75 mV 

Also Q waves in V5 or V6 > 4 mV is a useful sign of LVH 

Biventricular hypertrophy 

R + S in V4 

> 1 year 

> 5 mV 


Suggested pain management 

The plan of anaesthesia should always include postoperative analgesia. 

Analgesic ladder 

Increasing pain 

severe 

slight 

mild 

Paracetamol 

+ 

NSAID 

moderate 

Paracetamol 

NSAID + 

weak opioid 

eg. codeine 

Paracetamol, 

NSAID + 

potent opioid 

eg. Morphine 

Paracetamol 

• Use a multi-modal 

approach 

p using a combination of drugs from the following four 

groups is logical: 

• Local anaesthesia 

• Paracetamol 

• NSAIDS 

• Opioids 

• Follow analgesic 

protocols 

p are available in individual hospitals which are written 

to suit local circumstances and are updated from 

time to time 


Local anaesthesia procedures 

Use of local anaesthesia should be considered for every paediatric case. 

• Dont forget 

wound 

infiltration 

p It is simple to perform and improves early postoperative 

analgesia when other medications may be inadequate or 

difficult to administer 

• Procedures Group 1 p Ilioinguinal / Iliohypogastric nerve block 

p Ilioinguinal / Iliohypogastric / genital branch 

of genitofemoral 

p Penile *(may be considered a Group 2 procedure) 

p Rectus sheath block 

p Caudal epidural 

Group 2 

Group 3 

p Femoral nerve block 

p 3 in 1 block / Fascia Iliaca block 

p Axillary brachial plexus block 

p Lumbar epidural 

p Paravertebral block 

p Spinal block in the neonate 

p Thoracic epidural 

• Training p Trainees should be experienced and competent in Group 1 

procedures, and at least able to describe the indications 

and techniques for those in Groups 2 and 3 

p Guidance can be found in a number of texts, see 

‘recommended reading’ section 


Paediatric analgesia & anti-emetics 

Drug Dose Comments 

PARACETAMOL 

NEONATES: 

Oral: Loading dose: 15 mg/kg 

Then: 10 - 15 mg/kg dose 

Max dose: 60 mg/kg/day 

Rectal: 

Loading dose: 20 mg/kg 

Then: 15 mg/kg dose 


Mild analgesic and anti-pyretic 

drug 

Limit to 5 days duration 

OTHERS: 

Oral: 

Rectal: 

Loading dose: 20 mg/kg 



Loading dose: 30 – 40 mg/kg 



DICLOFENAC Oral / Rectal: 1 mg/kg 8 hourly 

Max dose: 50 mg 

Max daily dose: 150 mg/day 

Not neonates or infants < 6 mths 

Caution in asthma or renal 

impairment 

IBUPROFEN Oral: 5 mg/kg 6 hrly 



Not neonates or infants < 6mths 

Caution in asthma or renal 

impairment 

CODEINE Oral / Rectal: 1 - 1.5 mg/kg 4 - 6 hrly 

IM: 1 mg/kg 4 - 6 hrly 


Combine with paracetamol. 

Must never be given IV - 

hypotension occurs 

MORPHINE Oral: ≥ 1 yr 200 - 400 mcg/kg 4 hrly 

IV: 

Loading dose: 50 - 100 mcg/kg 

Infusion: 10 - 30 mcg/kg/hr 

Monitor respiration 

Always prescribe NALOXONE 

PRN for respiratory depression 

MORPHINE INFUSION 

PROTOCOL 

(for age ≥ 6 mths with 

suitable monitoring 

Morphine sulphate 0.5 mg/kg 

in 50 mls solution 

Rate: 1 - 3 ml/hr (1 ml/hr = 10 mcg/kg/hr) 

PCA & NCA - if available, 

consult protocols at individual 

hospitals 

NALOXONE IV: 4 micrograms/kg For respiratory depression: 

< 5 yrs rate < 20/min 

≥ 5 yrs rate < 10/min 

CYCLIZINE Oral / IV: 1 mg/kg 



ONDANSETRON Oral / IV: 100 mcg/kg 


Frequency 8 hourly 

Anti-emetics may be combined 

Frequency 8 hourly 

Anti-emetics may be combined 



Fluid balance 

suggested intraoperative fluid management 

• Objectives 

• Maintain normal circulating volume 

• Maintain normal electrolyte balance 

• Maintain normoglycaemia 

• Maintain haemoglobin at an appropriate level 

The following regime is a guide to fluid management 

1. Replace fluid deficit due 

to starvation 

CALCULATION 

the hourly maintenance fluid x no. hours starvation 

2. Give intraoperative 

maintenance fluids 

for example 

3. Replace on-going fluid 

losses 

Intraoperative fluid should be given as Hartmans solution 1 . 

Maintenance fluids should be calculated according to the 

following formula: 

Body weight (kg) 

First 10 kg 

Second 10 kg 

Subsequent kg 

a 6 kg infant would require 24 ml/hr 

a 14 kg child would require 48 ml/hr 

a 25 kg child would require 65 ml/hr 

• Measure / estimate blood loss 

• Estimate ‘third space’ losses 

Fluid requirement per hour 

4 ml/kg 

2 ml/kg 

1 ml/kg 

On-going fluid losses should be replaced with Hartmans, colloid 

(gelatin) or blood. Blood replacement and optimum haemoglobin 

levels should be discussed preoperatively. 

Large volumes may be required to replace third space losses 

and should be guided by clinical monitoring 

• Minor surgical procedures 1 ml.kg -1 .hr -1 

• Major abdominal procedures up to 15-20 ml.kg -1 .h -1 

• Assessment and 

reassessment of the 

cardiovascular system 

Fluid replacement should be guided by assessment and 

reassessment of the cardiovascular system (capillary refill, HR, 

BP, CVP, blood gases and haematocrit as appropriate) 


Hypoglycaemia and hyperglycaemia are potentially harmful. Dextrose containing solutions tend to cause 

intraoperative hyperglycaemia. However, if a child is ALREADY receiving 10% dextrose preoperatively, this should 

be continued as the intraoperative maintenance fluid. Blood glucose should be measured during surgery. 

• Basic monitoring assumed 

• Exercise CAUTION if diagnosis is not certain 

Recommended emergency management of 

Acute major anaphylaxis under anaesthesia 

IMMEDIATE MANAGEMENT 

SECONDARY MANAGEMENT 

Discontinue administration of suspect drug 

Summon help 

Maintain airway with 100% oxygen 

(consider tracheal intubation and IPPV) 

Give ADRENALINE 

0.05 - 0.1 ml/kg of 1:10,000 ie. 5 - 10 mcg/kg 

especially if bronchospasm present. 

Further similar doses may be necessary for 

hypotension and bronchospasm. 

Continuous infusion may be necessary 

0.1 - 0.5 mcg/kg/min 

To make solution: 300 mcg/kg in 50 mls 

Start at: 1 ml/hr - 0.1 mcg/kg/min 

Start intravascular volume expansion 

with Hartmann’s or saline solution 

Initially: 10 - 20 ml/kg bolus - rapidly 

Repeat as necessary 

Consider external chest compressions 

When patient has stabilised 

• Blood samples should be taken and placed in 

plain tubes as soon as possible at 1, 2, 4 and 

12 hour intervals and put in a fridge until 

analysed 

ADRENALINE-RESISTANT BRONCHOSPASM 

Consider: 

• SALBUTAMOL 

Loading dose: 5 mcg/kg IV 

Then: 

0.2 - 4 mcg/kg/min 

(3 mg/kg in 50 ml 1 ml/hr = 1 mcg/kg/min) 

Or: 

• AMINOPHYLLINE 

Bolus over 20 min: 

Then: 

5 mg/kg IV 

800 mcg/kg/hr 

CONSIDER: 

1. Steroids 

• HYDROCORTISONE 4 mg/kg IV 

Or: 

• METHYLPREDNISOLONE 

500 mcg-1 mg/kg IV up to max dose: 4 mg/kg 

And: 

2. Antihistamines 

• • CHLORPHENIRAMINE 

(diluted and given slowly over one minute) 

< 1 year 250 mcg/kg IV 

1 - 5 yrs 2.5 - 5 mg IV 

6 - 12 yrs 5 - 10 mg IV 

> 12 yrs 10 - 20 mg IV 

ACIDOSIS 

If severe after 20 min: 

SODIUM BICARBONATE 

Catecholamine infusions 

0.5 - 1 mmol/kg 

ADRENALINE Dose range 

NORADRENALINE 0.1-0.5 mcg/kg/min 

To make solution: 300 mcg/kg in 50 ml 

Start at: 1 ml/hr = 0.1 mcg/kg/min 

• Immunology should then be contacted about 

the investigation 

• The drug, fluid or blood thought to be 

responsible for the reaction should also be 

saved 

Clotting screen 

Consider possibility of coagulopathy 

Measure arterial blood gas tensions 

for oxygenation and acid-base status 


Recommended emergency management of 

Malignant Hyperthermia 

Signs and Symptoms 

ACTIVE COOLING to include 

MONITORING to include 

↑ End tidal CO2 

Tachycardia 

Fever 2 0 C per hour 

Cyanosis 

Mottling of skin 

Tachypnoea 

Arrhythmias 

Rigidity 

Sweating 

Hypercarbia 

Labile blood pressure 

Intense masseter spasm after 

suxamethonium 

Ice packs 

Cooling blankets 

Fans 

Cold intravenous fluids 

Intragastric, intracystic cooling 

Peritoneal dialysis using cold 

diasylate 

Extracorporeal cooling if 

equipment is available 

 

 

 

 

 

 

 

 

 

 

Core temperature 

Arterial line and CVP line 

Urinary catheter 

ECG 

Pulse oximetry & capnography 

Blood gases 

Serum glucose 

Serum potassium 

Blood for CPK 

Urine for myoglobin 

IMMEDIATE MANAGEMENT 

Terminate anaesthesia and surgery as soon as possible 

SUMMON HELP 

Hyperventilate with 100% oxygen through vapour-free circuit and convert 

to narcotic-relaxant technique during termination of surgery 

DANTROLENE 2.5 mg/kg IV 

Repeat as required at 5.10 min intervals to a maximum cumulative dose of 10 mg/kg 

Favourable response indicated by (a) fall in heart rate (c) decline in body temperature 

(b) abolition of arrhythmia (d) reduced muscle tone 

DANTROLENE should be available in or near operating theatres. Make sure you know where to find it! 

START ACTIVE COOLING 

• ARRHYTHMIAS 

If these persist despite Dantrolene give: 

PROCAINAMIDE 1 mg/kg/ml IV 

Maximum dose: 15 mg/kg 

• ACIDOSIS 

Correction with 

SODIUIM BICARBONATE 

0.5 - 1.0 mmol/kg/dose IV 

Repeated as necessary 

• HYPERKALAEMIA 

Control if necessary using glucose and 

INSULIN 0.1 units/kg in 2 ml/kg 50% dextrose IV 

• URINE OUTPUT 

MANNITOL 0.5 - 1.0 g/kg 

(2.5 - 5ml/kg of 20% solution) and/or 

FRUSEMIDE 1 mg/kg IV 

to maintain urine output (> 1 ml/kg/hr) 

TRANSFER TO ICU as soon as possible 

Recurrence of hyperthermia may occur during first 24 hours 

WHEN PATIENT IS STABILISED 


arrange investigation of patient and relatives 


1. 

Recommended management of Latex Allergy 

THREE GROUPS OF PATIENTS EXIST 

Group 1 History of anaphylaxis to latex 

Group 2 History of allergy to latex or rubber 

eg. urticaria, central dermatitis, 

eye swelling, bronchospasm 

Group 3 High risk group: 

No previous reaction but have 

a) Spina bifida 

b) Genitourinary anomalies 

c) Multiple surgical procedures 

d) Documented reactions to IV drugs 

PREMEDICATION 

GROUPS 1 and 2 should be treated identically 

IV MEDICATION 

i) Methylprednisolone 1 mg/kg 6 hrly IV 

Max dose 50 mg/dose 

ii) Ranitidine 1 mg/kg 6 hrly IV 

over 2 mins 

iii) Chlorpheniramine 1 mth-1 yr 250 mcg/kg 

1 - 5 yrs 2.5-5 mg 

6 - 12 yrs 5-10 mg 

All doses IV 6 hrly GIVEN SLOWLY 

Notes: 

i) At lease two doses must be given preoperatively 

and continued 24 hours postoperatively 

ii) Diluents must not be added to vials through rubber 

bungs. The bung must be removed or dispensing 

pin with filter (eg. Braun) to be used 

PATIENTS WITH ASTHMA 

Salbutamol inhaler 6 hrly 2 doses preoperatively 

GROUP 3 High risk patients 

No special precautions 

Maintain high index of suspicion during and after case 

TREATMENT OF ANAPHYLAXIS TO LATEX 

As per Anaphylaxis Protocol 

• Anaphylaxis may be slow in onset and difficult to 

diagnose 

• A smaller dose of epinephrine may be used if 

reaction is not severe 

In addition give: 

i) Methylprednisolone 1 mg/kg IV 

ii) Chlorpheniramine 1 mth-1 yr 250 mcg/kg IV 

1-5 yrs 2.5-5 mg IV 

6-12 yrs 5-10 mg IV 

iii) Ranitidine 

1 mg/kg slowly IV 

AIM 

MANAGEMENT IN THEATRE 

To prevent any contact between the 

patient and products containing latex 

SAFE EQUIPMENT 

should be used wherever possible 

The following equipment IS safe: 

GLOVES - latex free 

• Regent - Neotech • Ansell - Dermaprene 

RESPIRATORY EQUIPMENT 

• Clear silicone masks eg - King Systems Leardal 

• Tracheal tubes Portex 

• Airways Geudel 

• Filter should be placed at patient end of the 

breathing circuits 

• Polythene bags should be placed over reservoir 

bag of Bain circuit if used (in Group 1 patients only) 

• Laryngeal masks 

INTRAVENOUS EQUIPMENT 

• IV cannulae Jelco, Venflon, Neoflon, Abbocath 

• Latex free syringes BD Discardit 

• Latex free giving sets DOSIFIX - Braun - fluids 

SANGOFIX - Braun - blood 

• IV giving sets with latex port can be used but 

injections should not be made through these parts 

- cover with tape 

• Dispensing pin with filter (eg. Braun) used to 

draw or mix drugs held in ampoule with rubber bung 

• Do not mix or draw up drugs through rubber bungs 

• CVP Cook - Vygon - Arrow 

Avoid injecting through rubber bungs 

• Syringe pump infusion eg PCA/NCA/Epidural 

Use ordinary syringes with an Intrapur extension 

(Braun) with filter between syringe and giving set 

MONITORING EQUIPMENT 

• ECG electrodes Nelcor - Medicotest 

• BP cuff has to be covered with tape or use 

Disposa Cuff (J&J) 

• Operating table & trolley Avoid contact with 

mattress by covering with sheet 

• Tape / Dressings (avoid elastoplast) 

• Transpore (3M), Micropore (3M), Tegaderm (3M) 

Hyperfix (Smith & Nephew), Steristrips (J&J) 

• NG tubes Vygon - Portex 

• Suction catheter & tubing Penine 

• Yankauer sucker Argyle 

• Epidural catheter Portex 

• Diathermy 3M plate and lead safe 

• Temperature probes Disposable probes can be used 

OTHER POINTS 

• Patient must be first on list 

• Avoid touching latex products and then touching pt 

• All staff in dept involved made aware of status 

• Reduction of numbers in theatres where possible 

• Notices in theatre involved 


General recommendations 

Sickle Cell Disease 

suggested perioperative management 

• Sickle cell disease (SCD) is a chronic debilitating disease associated with significant perioperative morbidity 

and mortality. Meticulous perioperative care is required. Families are generally well informed about the 

condition and appreciate being involved in decisions about care. 

• Elective surgery 

• Admission 

• Scheduling operation 

• Precipitating factors 

Preoperative preparation checklist 

‣ Children with SCD presenting for elective surgery should be discussed 

with the anaesthetists and haematologists preoperatively. A plan for 

preoperative transfusion will be formulated depending on the child’s 

condition and the nature of the intended surgery. Preparation for 

surgery may take at least three weeks as below. 

‣ Children should be admitted the day before surgery. 

They require blood of the appropriate phenotype to be crossmatched 

which may take up to 6 hours. 

‣ Children should be scheduled early on the operating list to ensure that 

they are not cancelled. 

‣ Care should be taken at all times to avoid factors that may precipitate a 

sickle crisis. These include dehydration, hypoxia, acidosis, hypothermia 

and pain. The majority of crises occur postoperatively. 

1. Inform Haematology Team ‣ that a child with sickle cell disease has been admitted 

They will help co-ordinate with the haematology laboratory 

2. Take blood ‣ for full blood count and electrophoresis (%HbS, HbA, HbF) 

3. Crossmatch ‣ 1 unit phenotyped blood for all cases 

4. Start intravenous 


5. Consider postoperative 

nasal CPAP 

‣ 12 hours preoperatively for all cases 

‣ if the child has a history of severe obstructive sleep apnoea 

Postoperative care 

1. Monitor saturation ‣ give oxygen to maintain saturation ≥ 92% 

continuously 

2. Continue intravenous ‣ until the child is tolerating oral fluids 


3. Postoperative analgesia ‣ ensure this is adequate 

4. Contact physiotherapy ‣ encourage early mobilisation 

Postoperative sickling complications 

• Serious postoperative complications (usually within 48 hours of surgery) include: 

They may be accompanied by fever and may coexist. 

1. Inform Haematology Team ‣ if any of the above are suspected 

2. Treatment of Sickle crisis 

includes: 

• Over transfusion and hyperviscosity must be avoided 

• painful crisis 

• cerebral event 

• chest crisis 

‣ intravenous fluids ‣ oxygen therapy ‣ antibiotics 

‣ analgesia as indicated ‣ transfusion to Hb>10 g/dl (but

- discuss early with the PICU Team 

Sickle Cell Disease 

suggested transfusion policy 

This transfusion policy has been agreed locally by the haematologists and anaesthetists at GOSH and 

referring paediatricians. 

Transfusion recommendations for elective surgery 

Patients with a history of severe sickle related problems, such as chest crisis, CNS disease, or frequent painful 

crises, or with severe obstructive sleep apnoea or patients undergoing major surgery, have been found to be at 

greater risk of serious perioperative complications. However, aggressive transfusion regimens or emergency 

transfusions with blood of inappropriate red cell phenotype are associated with a higher incidence of transfusion 

related complications. A four tiered approach is recommended, tailored to suit the individual case. 

Group 1 

Group 2 

Group 3 

Group 4 

‣ Children with no special risk factors, who are currently well, having short procedures 

with minimal risk of perioperative complications eg. insertion of grommets: 

‣ Top-up transfusion to Hb >7 g/dl only, irrespective of HbS level 

‣ Children with no special risk factors, having intermediate risk surgery eg. body surface 

surgery such as herniorrhaphy, or tonsillectomy in older children with mild to moderate 

obstructive sleep apnoea: 

‣ Top-up transfusion to Hb 9-11 g/dl, irrespective of HbS level 

‣ Total Hb should not exceed 12 g/dl 

‣ Children who have had a chest crisis or suffer frequent painful crises, or children 

undergoing major surgery eg. intra-abdominal surgery (including laparoscopic surgery), or 

tonsillectomy in children

ecommended reading materials Textbooks 

title author / editor publisher 

• Manual of pediatric anesthesia Steward, David Churchill Livingstone 

London: 1995 

• Pediatric Anesthesia Gregory, George A Churchill Livingstone 

London: 1994 

• The surgical neonate: 

Anaesthesia and Intensive Care 

• Textbook of paediatric 

anaesthetic practice 

• Pain in infants, children and 

adolescents 

• Regional anaesthesia for 

babies and children 

Hatch, David 

Sumner, Edward 

Hellman, Jonathan 

Hatch, David 

Sumner, Edward 

Schechter, Neil 

Berde, Charles 

Yaster, Myron 

Peutrel, Jane M 

Mather, Stephen J 

Arnold 

London: 1994 

Arnold 

London: 1999 

Williams and Wilkins 

London: 1992 

New edition in preparation 

Oxford University Press 

Oxford: 1997 

• Pediatric cardiac anesthesia Lake, Carol Applleton and Lange 

London: 1997 

• Anesthesia and uncommon 

pediatric diseases 

• Anesthetic management of 

difficult and routine pediatric 

patients 

Katz 

Steward 

Berry, Frederic 

W B Saunders 

London: 1993 

Churchill Livingstone 

London: 1990 

• Practice of paediatric ICU Rogers Williams & Wilkins 

London: 1987 

• Forfar and Arneil’s Textbook of 

Pediatrics 

• Users’ guides to the medical 

literature. A manual for 

evidence-based clinical 

practice 

• Evidence-Based Medicine – 

How to practice and teach EBM 

Helms, P 

Guyatt, G 

Rennie D 

Sackett, DL 

Straus, SE 

Richardson, WS 

Rosenberg, W 

Haynes, RB 


London, new edition in press 

2002 

Journal of American Medical 

Association Archive Press 

2002, pp 55-79 

2 nd Edition 


Edinburgh: 2000 



ecommended reading materials Journals 

(with significant paediatric content) 

title editors publisher 

• Paediatric Anaesthesia Sumner, Edward Blackwell Science 

Oxford 

• Anesthesiology Todd, Michael American Society of Anesthetists 

JB Lippincott Company 

Philadelphia 

• Anesthesia and Analgesia Miller, Ronald D Lippincott, Williams and Wilkins 

International Anesthetist Research 

Society 

Hagerstown, MD USA 

• British Journal of 

Anaesthesia 

• Canadian Journal of 

Anaesthesia 

• Archives of Disease in 

Childhood 

Hunter, JM 

Craig, Douglas B 

Chiswick, Malcolm 

Marcovitch, Harvey 

Royal College of Anaesthetists 

BMJ Publishing Group 

Canadian Anaesthetists Society 

Toronto 

Royal College of Paediatrics and 

Child Health 

BMJ Publishing Group 

• Anaesthesia Harmer, M Association of Anaesthetists of 

Great Britain and Ireland 

Blackwell Science 

• Current Opinion in 

Anesthesiology: Paediatric 

Issues 

Prys-Roberts, Cedric 

Lippincott, Williams & Wilkins 

London 


ecommended reading materials Useful publications 

title 

• Medicines for children 

Royal College of Paediatrics and Child 

Health Formulary 

• GOSH Drug Administration 

Guidelines 

Great Ormond Street Hospital Anaesthesia 

and Pain Formulary 

source 

RCPCH and NPPG 

RCPCH Publications Ltd 

50 Hallum St, London W1N 6DE 

GOSH Trust Print and Publications Unit 

C/o Dept of Anaesthesia 

GOSH, London WC1N 3JH 

(available by post at £6 per copy) 

• Prevention and control of pain in 

children. A Manual for Health Care 

Professionals 

• NCEPOD 

National confidential enquiry into 

perioperative deaths 

• Welfare of children and young 

people in hospitals (1991) 

• Just for the day – children admitted 

to hospital for day treatment (1991) 

• Children first – a study of hospital 

services (1993) 

• The transfer of infants and children 

for surgery: report of a joint 

working group (1993) 

• Children’s surgical services: report 

of an ad hoc multi-disciplinary 

children’s surgical liaison group 

(1996) 

• Guidelines for the provision for 

anaesthetic services 

(1994 updated 1999) 

• Children’s Surgery – a First Class 

Service (2000) 

• Learning from Bristol 

The Bristol Royal Infirmary Inquiry 

(2001) 

Royal College of Paediatrics and Child Health 

BMJ publishing, London WC1 

NCEPOD (1989) - Paediatric surgery/anaesthesia 

NCEPOD (1998-99) - Extremes of age 

Department of Health 

HMSO, 40 High Holborn WC1, London 

Mail Order 020 7873 0011 

Caring for children in the Health Services 

Action for Sick Children, London 

Audit Commission 


Mail Order 020 7873 0011 

British Paediatric Association / Royal College of 

Paediatrics and Child Health 

Royal College of Paediatrics and Child Health 

50 Hallum St, London W1N 6DE 

Royal College of Anaesthetists 

48-49 Russell Square, London WC1B 4JP 

Report of the Paediatric Forum of the Royal College of 

Surgeons of England. 

Royal College of Surgeons of England, 35 Lincoln’s Inn 

Fields, London WC2 


Mail Order 020 7873 0011 



ecommended reading materials Internet resources 

• Paediatric Resources 

PEDINFO: An Index of the Pediatric 

Internet 

Australian Paediatric Resource 

Directory 

Emory University Paediatric 

Resources 

Cedars-Sinai Medical Center 

The University of Washington NICU 

Web 

• Anaesthetic Resources 

The Metro Health System in 

Cleveland 

The University of Sydney 

The Association of Ottawa 

Anesthesiologists 

Paediatric Anaesthesia Journal 

• Technology in Anaesthesia 

Society for Technology in 

Anesthesia 

Society for Computing and 

Technology in Anaesthesia 

Journal of Clinical Monitoring and 

Computing 

Tech Talk’ Discussion Group 

• General Resources for Anaesthetists 

Medical Matrix 

The Gasnet Global Textbook of 

Anesthesiology 

The WWW Virtual Library: 

Anesthesiology. 

Virtual Anaesthesia Textbook 

The Hardin Meta Directory for 


The CSEN Global List of Web sites 

on Anaesthesia 

Medmark 

address 

http://pedinfo.org/ 

http://www.cundle.com.au/gen/paeds/paedsres.html 

http://www1.cc.emory.edu/PEDS/gen-ped.htm 

http://www.csmc.edu/pediatrics/demo.990525.html 

http://neonatal.peds.washington.edu/ 

http://metrohealthanesthesia.com/links.htm 

http://www.usyd.edu.au/su/anaes/anaes.html 

http://www.anesthesia.org/professional/linkanes.html 

http://www.blacksci.co.uk/~cgilib/jnlpage.bin?Journal=PAN&File=PAN&Page=links 

http://gasnet.org/sta/ 

http://www.scata.org.uk/ 

http://www.wkap.nl/journalhome.htm/0167-9945 

http://www.sickkids.on.ca/Anaesthesia/TechTalk_DG.asp 

http://www.medmatrix.org/_SPages/Anesthesiology.asp 

http://gasnet.org/gta/ 

http://www.gasnet.org/vl/vl.php3 

http://www.virtual-anaesthesia-textbook.com/ 

http://www.arcade.uiowa.edu/hardin-www/md-anesth.html 

http://www.csen.com/anesthesia-websites/ 

http://medmark.org/anes.ane2.html 

The Virtual Hospital 

• Anaesthetic Departments 

The Packard Children’s Hospital in 

Stanford 

The Virtual Children’s Hospital 

The Mott Children’s Hospital in Ann 

Arbor 

The University of Wisconsin major 

topics in anesthesia 

Alberta Children’s Hospital in 

Calgary 

http://www.vh.org/ 

http://www.pedsanesthesia.stanford.edu/guidelines/ 

http://www.vh.org/VCH/Providers.Information.html 

http://www.anes.med.umich.edu/pediatrics/default.htm 

http://www.anesthesia.wisc.edu/Topics/Pediatric_Anesthesia/ped_anesth.html 

http://www.crha-health.ab.ca/clin/anaesth/paed/paed.htm 


The Women’s and Children’s 

Hospital in Adelaide 

http://www.wch.sa.gov.au/paed-anaes/pgi/index.html 


Internet Resources (cont) 

• International Societies 

The Association of Paediatric 

Anaesthetists of Great Britain and 

Ireland 

The Federation of European 

Associations of Paediatric 

Anaesthetists 

The Society for Pediatric Anesthesia 

Society for Paediatric Anaesthesia in 

New Zealand and Australia 

French Speaking Association of 

Paediatric Anaesthetists 

Italian Society for Paediatric and 

Neonatal Anaesthesia and Intensive 

Care 

• General Paediatric References 

Pediatric Points of Interest 

The American Academy of 

Pediatrics 

General Pediatrics.com 

The Vanderbilt Pediatric Interactive 

Digital Library 

• Rare diseases 

PEDBASE 

National Organisation for Rare 

Disorders 

Online Mendelian Inheritance in Man 

• Paediatric Subsections 

WebPath 

The VCH Imaging Encyclopædia of 

Pediatric disease 

The Digital Library of Paediatric 

Radiology 

The University of Cleveland 

radiology Web site 

Rush Children’s Hospital 

The Children’s Health Information 

Network 

The University of Kansas Paediatric 

teaching files 

address 

http://www.apa-gbi.org/ 

http://free.med.pl/feapa/ 

http://www.pedsanesthesia.org/ 

http://www.spanza.org.au/ 

http://www.invivo.net/adarpef/pedia.htm 

http://utenti.tripod.it/SARNePI 

http://www.med.jhu.edu/peds/neonatology/poi.html 

http://www.aap.org/bpi/default.htm 

http://www.generalpediatrics.com/ 

Http://www.mc.vanderbilt.edu/peds/pidl/index.htm 

http://www.icondata.com/health/pedbase/pedlynx.htm 

http://www.rarediseases.org/rdb/over.htm 

http://www3/mcbi/nlm.nih.gov/omim/ 

Pathology 

http://www-medlib.med.utah.edu/WebPath/PEDHTML/PEDIDX.html 

Radiology 

http://www.vh.org/Providers/TeachingFiles/PAP/PAPHome.html 

http://www.pediatricradiology.com/ 

http://uhrad.com/pedsarc.htm 

Cardiology 

http://www.rchc.rush.edu/ped%20card%20prof.htm 

http://www.tchin.org/ilinks/profess/c_profess.htm#P01 

http://www.kumc.edu/kumcpeds/cardiology/cardiology.html 


Internet Resources (cont) 

• Paediatric Subspecialties 

Pediatric Critical Care Medicine 

St Paul’s Neonatal Intensive Care 

Unit 

Neonatology On the Web 

The University of Minnesota 

Neonatology teaching files 

The University of Miami ‘Hot 

Neonatology Web sites’ 

The Paediatric Pain Research Lab 

Oxford Pain Internet site 

Bandolier Home Page 

Pain.com 

The Toronto Paediatric Anesthesia 

Conference – Discussion Group 

Gasnet Anesthesiology Discussion 

Group 

• Online journals 

Anaesthesia Web free online 

journals 

The Internet Journal of 


• Anaesthesia Simulators 

The University of Rochester 

International Simulator list 

The Bristol Medical Simulation 

Centre 

• Palm Computing Web sites 

Medical software for EPOC 

Medical PDA site 

Palm Medicine 

Tucows 

address 

Critical care and Neonatology 

http://pedsccm.wustl.edu/PedsCCM_Home_page.html 

http://www.peds.umn.edu/divisions/neonatology/spnicu/guide.html 

http://www.neonatology.org/neo.links.web.html 

http://www.peds.umn.edu/divisions/neonatology/tfiles/tf.html 

http://members.home.net/cotton/neoweb.html 

Pain 

http://is.dal.ca/~pedpain/ 

http://www.jr2.ox.ac.uk/Bandolier/painres/painpag/index.html 

http://www.jr2.ox.ac.uk/bandolier/ 

http://www.pain.com/ 

Discussion Groups 

http://www.sickkids.on.ca/anaethesia/pac_dg.asp 

http://gasnet.org/maillist/ 

http://www.aims.org.sg/saw/elecjourl.htm 

http://www.ispub.com/journals/ija.html 

http://web.anes.rochester.edu/simulate/webpages.htm 

http://bristol.ac.uk/Depts/BMSC/ 

http://dnausers.d-n-a.net/psionmed/psimed/soft5.htm 

http://www.pdamd.com/ 

http://hometown.aol.com/roboh98/palm.html 

http://pda.tucows.com/epoc/mecical5.htm 


ecommended reading materials Key references 

General 

Association of Anaesthetists. Anaphylactic reactions associated with anaesthesia, 1990. 

Phillips S, Daborn AK and Hatch DJ. Perioperative fasting for paediatric anaesthesia. 

Anaesthesia 1994; 73(4): 529-36. 

British Journal of 

McEwan AI, Birch M and Bingham R. The preoperative management of the child with a heart murmur. 

Paediatric Anaesthesia 1995; 5(3):151-156. 

Steward D. Malignant hyperthermia. Manual of Paediatric Anaesthesia, 163- 170. 

Bacterial Endocarditis. Lancet 1992; 339: 1292-1293. 

Bacterial Endocarditis. Journal of the American Medical Association 1997; 227: 1794-1801. 

Upper respiratory tract infections 

Tait AR and Knight PR. Intraoperative respiratory complication in patients with upper respiratory tract 

infections. Canadian Journal of Anaesthesia 1987. 

Tait AR and Knight PR. The effects of general anaesthesia on upper respiratory tract infections in children. 

Anesthesiology 1987. 

Desoto H. Changes in oxygen saturation following general anaesthesia in children with upper respiratory 

infection signs and symptoms undergoing otolaryngological procedures. Anesthesiology 1988. 

Anaesthesia and upper respiratory tract infections - a non-existent hazard. (editorial) British Journal of 

Anaesthesia May 1990. 

Cohen MM and Cameron CB. Should you cancel an operation when a child has an upper respiratory tract 

infection? Anesthesia and Analgesia 1991. 

Levy L and Tait AR. Upper respiratory tract infection and general anaesthesia in children. 

1992. 

Anaesthesia 

Tait AR et al. Risk factors for perioperative adverse respiratory events. Anesthesiology 2001; 95: 299-306. 

Sickle cell 

Vichinsky E et al. A comparison of conservative and aggressive transfusion regimens in the perioperative 

management of sickle disease. New England Journal of Medicine 1995; 333: 206-13. 

Waldron et al. Tonsillectomy, adenoidectomy and myringotomy in sickle cell disease: perioperative 

morbidity. Journal of Pediatric Hematology / Oncology 1992; 21(2): 129-135. 

Adams et al. Successful surgical outcome in children with sickle hemaglobinopathies: the Duke University 

experience. Journal of Pediatric Surgery 1998; 33: 428-432. 

Yardumian and Rossiter. The North Middlesex Hospital Guidelines for preparation of children with sickle cell 

disease for surgery. (Personal communication) 

Organisation 

National confidential enquiry into perioperative deaths 1989. The Royal College of Surgeons of England. 

The Royal College of Anaesthetists. 

Welfare of children and young people in hospitals. Department of Health, HMSO, London 1991. 

Just for the day – children admitted to hospital for day treatment. Caring for children in the Health Services, 

London 1991. 

Children first – a study of hospital services. Audit Commission, HMSO, London 1993. 


British Paediatric Association / Royal College of Paediatric and Child Health. The transfer of infants and 

children for surgery: report of a joint working group, 1993. 

Royal College of Paediatrics and Child Health. Children’s surgical services: report of an ad hoc multidisciplinary 

children’s surgical liaison group, 1996. 

Key references (cont) 

Paediatric intensive care: a framework for the future. National Co-ordinating Group on Paediatric Intensive 

Care / NHS Executive, 1997. 

National confidential enquiry into perioperative deaths. Extremes of age. NCEPOD London 1999. 

Royal College of Surgeons of England. Report of the Paediatric Forum of the Royal College of Surgeons of 

England. Children’s Surgery – a First Class Service, 2000. 

Guidelines for the provision for anaesthetic services. Royal College of Anaesthetists 1994, updated 1999. 

Learning from Bristol. The Bristol Royal Infirmary Inquiry. HMSO 2001. 

Fluid balance 

AI Arieff. Postoperative hyponatraemic encephalopathy following elective surgery in children. 

Anaesthesia 1998; 8: 1-4. 

Paediatric 

Nattie EE and Edwards WH. Brain and CSF water in newborn puppies during acute hypo and 

hypernatraemia. Journal of Applied Physiology 1981; 51: 1086-1091. 

Holliday MA and Segar WE. The maintenance need for water in parenteral fluid therapy. Paediatrics 1957; 

19: 823-832. 

Berry FA. Practical aspects of fluid and electrolyte therapy. Berry FA, (ed). Anaesthetic Management of 

Difficult and Routine Pediatric Patients. 2 nd ed. New York: Churchill Livingston 1990: 89-120. 

Scheingraber S, Renm M, Sehmisch C et al. Rapid saline infusion produces hyperchloremic acidosis in 

patients undergoing gynaecologic surgery. Anesthesiology 1999; 90: 1265-1270. 

Hatch D, Sumner E and Hellman J. The surgical neonate. The surgical neonate: Anaesthesia and Intensive 

Care. 3 rd ed. London: Edward Arnold, 1995: 104-110. 

Huskisson L. Fluid balance: all aspects. Paediatric Anaesthesia. 2 nd ed. London: Arnold, 2000: 233-248. 

Leelanukrom R and Cunliffe M. Intraoperative fluid and glucose management in children. 

Anaesthesia 2000; 10: 353-359. 

Paediatric 

Sandstorm K, Larsson LE and Nilsson K. Four different fluid regimes during and after minor paediatric 

surgery – a study of blood glucose concentrations. Paediatric Anaesthesia 1994; 4: 235-242. 

Srinivasan G, Jain R, Pildes RS et al. Glucose homeostasis during anaesthesia and surgery in infants. 

Journal of Pediatric Surgery 1986; 21: 718-721. 

Steward DJ. Hyperglycaemia, something to worry about! Paediatric Anaesthesia 1992; 2: 81-83. 

Jensen BH, Wernberg M and Andersen M. Preoperative starvation and blood glucose concentrations in 

children undergoing impatient and outpatient anaesthesia. British Journal of Anaesthesia 1982; 54: 

1071-1074. 

Payne K and Ireland P. Plasma glucose level in the peri-operative period in children. Anaesthesia 1984; 39: 

868-872. 

Tuckey J, Mather SJ and Thornton PGN. Can persistent cerebral damage be caused by hyperglycaemia? 

Paediatric Anaesthesia 1996; 6: 345-346 

Nakakimura K, Fleischer JE, Drummond JC et al. Glucose administration before cardiac arrest worsens 

neurologic outcome in cats. Anesthesiology 1990; 72: 1005-1011. 

Drummond JC and Moore SS. The influence of dextrose administration on neurologic outcome after 

temporary spinal cord ischaemia in the rabbit. Anesthesiology 1989; 70: 64-70. 


Longstreth WT, Diehr P, Cobb LA et al. Neurologic outcome and blood glucose levels during out-of-hospital 

cardiopulmonary resuscitation. Neurology 1986; 36: 1186-1191. 

Siker D. Paediatric fluids and electrolytes. Pediatric Anaesthesia 2 nd ed. New York: Churchill Livingstone 

1989: 581-617. 

Vincent JL. Fluids for resuscitation. British Journal of Anaesthesia 1991; 67: 185-193. 


Journal Club: publications of interest 

Updated: E Jackson May 2002 

Evaluation of Evidence see: 

A manual for evidence-based clinical practice. 

Eds. Guyatt G and Rennie D. Users Guides to the Medical Literature: 

Journal of American Medical Association 2002; pp 55-79. 

* latest/most recent references 

Premedication 

Brosius KK and Bannister CF. Effect of oral midazolam premedication on the awakening concentration of 

sevoflurane, recovery times and bispectral index in children. Paediatric Anaesth. 2001; 11(5): 585-590. 

* Brosius KK and Bannister CF. Oral midazolam premedication in preadolescents and adolescents. 

Anesthesia and Analgesia 2002; 94(1):31-6. 

* Lammers CR, Rosner JL, Crockett DE, Chhokra R and Brock-Utne JG. Oral midazolam with an antacid may 

increase the speed of onset of sedation in children prior to general anaesthesia. Paediatric 

Anaesthesia 2002; (1):26-8. 

Marhofer P, Freitag H, Hochtl A, Greher M, Erlacher W, Semsroth M. S(+)-ketamine for rectal premedication 

in children. Anesthesia and Analgesia 2001; 92(1): 62-5. 

General anaesthesia 

Aantaa R, Takala R and Muittari P. Sevoflurane EC50 and EC95 values for laryngeal mask insertion and 

tracheal intubation in children. British Journal of Anaesthesia 2001; 86(2): 213-216. 

* Anderson BJ and Meakin GH. Scaling for size: some implications for paediatric anaesthesia dosing. 

Paediatric Anaesthesia 2002; 12(3): 205-19. (review) 

Ayers J and Graves SA. Perioperative management of total parental nutrition, glucose containing solutions, 

and intraoperative glucose monitoring in paediatric patients. A survey of clinical practice. Paediatric 

Anaesthesia 2001; 11(1): 41-44. 

* Bannister CF, Brosius KK, Sigl JC, Meyer BJ and Sebel PS. The effect of bispectral index monitoring on 

anesthetic use and recovery in children anesthetized with sevoflurane in nitrous oxide. Anesthesia and 

Analgesia 2001; 92(4) 877-81. 

* Bellew M, Atkinson KR, Dixon G and Yates A. The introduction of a paediatric anaesthesia information 

leaflet: an audit of its impact on parental anxiety and satisfaction. Paed. Anaesth. 2002; 12(2): 124-30. 

Blanco G, Melman E, Cuairan V, Moyao D and Ortiz-Monasterio F. Fibreoptic nasal intubation in children 

with anticipated and unanticipated difficult intubation. Paediatric Anaesthesia 2001; 11(1): 49-53. 

* Bozkurt P. The analgesic efficacy and neuroendocrine response in paediatric patients treated with two 

analgesic techniques: using morphine-epidural and patient-controlled analgesia. Paediatric 

Anaesthesia 2002; 12(3): 248-54. 

* Brock-Utne JG. Is cricoid pressure necessary? Paediatric Anaesthesia 2002; 12(1): 1-4. 

* Bussolin L and Busoni P. The use of the cuffed oropharyngeal airway in paediatric patients. Paediatric 

Anaesthesia 2002; 12(1): 43-7. 

* Busoni P, Sarti A, Crescioli M, Agostino MR, Sestini G and Banti S. Motion sickness and postoperative 

vomiting in children. Paediatric Anaesthesia 2002; 12(1): 65-8. 


* Chambers N, Lopez T, Thomas J and James MF. Remifentanil and the tunnelling phase of paediatric 

ventriculoperitoneal shunt insertion. A double-blind, randomised, prospective study. Anaesthesia 

2002; 57(2): 133-9. 

* Chan CS and Molassiotis A. The effects of an educational programme on the anxiety and satisfaction level 

of parents having parent present induction and visitation in a postanaesthesia care unit. Paediatric 

Anaesthesia 2002; 12(2): 131-9. 

* Cheng CA, Aun CS and Gin T. Comparison of rocuronium and suxamethonium for rapid tracheal intubation 

in children. Paediatric Anaesthesia 2002; 12(2): 140-5. 

* Cohen IT, Hannallah RS and Hummer KA. The incidence of emergence agitation associated with 

desflurane anesthesia in children is reduced by fentanyl. Anesthesia and Analgesia 2001; 93(1): 88- 

91. 

Cote’ C. The upper respiratory tract infection (URI) dilemma. Anesthesiology 2001; 95(2): 283-285 

Davidson A, McCann M, Devavaram P, Auble S, Sullivan L, Gillis J M and Laussen P C. The difference in 

the bispectral index between infants and children during emergency from anesthesia after circumcision 

surgery. Anesthesia and Analgesia 2001; 93(2): 326-330. 

De Fatima, De Assuncao Braga, Da Silva Braga A, Poterio FM, Filier GM and Cremonesi PR. The effect of 

different doses of propofol on tracheal intubating conditions without muscle relaxant in children. 

European Journal of Anaesthesiology 2001; 18(6): 384-8. 

Degoute CS, Macabeo C, Dubreuil C, Duclaux R and Banssillon V. EEG bispectral index and hypnotic 

component of anaesthesia induced by sevoflurane: comparison between children and adults. British 

Journal of Anaesthesia 2001; 86(2): 209-12. 

Denman WT, Kaplan RF, Goudsouzian NG, Uejima T, Barcelona SL, Cote CJ, Ginsberg B and Hannallah 

RS. Intramuscular rapacuronium in infants and children: A comparative multicenter study to confirm 

the efficacy and safety of the age-related tracheal intubating doses of intramuscular rapacuronium 

(ORG 9487) in two groups of pediatric subjects. Anesthesiology 2001; 94(1): 3-7. 

Drake R, Anderson BJ, Persson MA and Thompson JM. Impact of an antiemetic protocol on postoperative 

nausea and vomiting in children. Paediatric Anaesthesia 2001; 11(1): 85-91. 

Duncan HP, Zurick NJ and Wolf AR. Should we reconsider awake neonatal intubation? A review of the 

evidence and treatment strategies. Paediatric Anaesthesia 2001; 11(2) 135-145. 

* Eikermann M, Renzing-Kohler K and Peters J. Probability of acceptable intubation conditions with low dose 

rocuronium during light sevoflurane anaesthesia in children. Acta Anaesthesiol. Scand. 2001; 45(8): 

1036-41. 

Engelhardt T, Strachan L and Johnston G. Aspiration and regurgitation prophylaxis in paediatric 

anaesthesia. (Survey) Paediatric Anaesthesia 2001; 11(2): 147-150. 

Erb T, Christen P, Kern C and Frei FJ. Similar haemodynamic, respiratory and metabolic changes with the 

use of sevoflurane or halothane in children breathing spontaneously via a laryngeal mask airway. Acta 

Anaesthesiol. Scand. 2001 45(5): 639-44. 

* Ferrari LR. Do children need a preoperative assessment that is different from adults? Int Anesthesiol Clin. 

2002; 40(2): 167-86. (review) 

* Fujii Y and Tanaka H. Preoperative oral granisetron for the prevention of vomiting following paediatric 

surgery. Paediatric Anaesthesia 2002; 12(3): 267-71. 

* Gan TJ, Madan R, Alexander R, Jhaveri R, El-Moalem H, Weatherwax K and Glass PS. Duration of action 

of vecuronium after an intubating dose of rapacuronium, vecuronium, or succinylcholine. Anesthesia 

and Analgesia 2001; 92(5): 1199-202. 

* Gasparoni A, Ciardelli L, De Amici D, Castellazzi AM, Autelli M, Bottino R,Polito E, Bartoli A, Rondini G and 

Chirico G. Effect of general and epidural anaesthesia on thyroid hormones and immunity in neonates. 

Paediatric Anaesthesia 2002; 12(1): 59-64. 


Golden S. Combination propofol-ketamine anaesthesia in sick neonates (case reports). 

Anaesthesia 2001; 11(1): 119-122. 

Paediatric 

* Hall SC. General pediatric emergencies. Malignant hyperthermia syndrome. Anesthesiol Clin North 

America 2001; 19(2): 367-82. (review) 

* Harrison JM, Girling KJ and Mahajan RP. Effects of propofol and nitrous oxide on middle cerebral artery 

flow velocity and cerebral autoregulation. Anaesthesia 2002; 57(1): 27-32. 

* Hayes AH, Breslin DS, Mirakhur RK, Reid JE and O'Hare RA. Frequency of haemoglobin desaturation with 

the use of succinylcholine during rapid sequence induction of anaesthesia. Acta Anaesthesiol Scand. 

2001; 45(6): 746-9. 

* Kaddu R, Bhattacharya D, Metriyakool K, Thomas R and Tolia V. Propofol compared with general 

anesthesia for pediatric GI endoscopy: is propofol better? Gastrointest. Endosc. 2002; 55(1): 27-32. 

Kardos A, Vereczkey G, Pirot L, Nyirady P and Mekler R. Use of impedance cardiography to monitor 

haemodynamic changes during laparoscopy in children. Paediatric Anaesthesia 2001; 11: 175-9. 

* Koinig H. Preparing parents for their child's surgery: preoperative parental information and education. 


Kulka P J, Bressem M and Tryba M. Clonidine prevents sevoflurane induced agitation in children. 

Anesthesia and Analgesia 2001; 93(2): 335-339. 

Le Berre PY, Wodey E, Joly A, Carre P and Ecoffey C. Comparison of recovery after intermediate duration 

of anaesthesia with sevoflurane and isoflurane. Paediatric Anaesthesia 2001;11(4):443-8. 

* Lejus C, Delaroche O, Le Roux C, Legendre E, Rivault O, Floch H, Renaudin M and Pinaud M. Does 

sevoflurane inhibit serum cholinesterase in children? Anaesthesia. 2002; 57(1): 44-8. 

* Litman RS, Weissend EE, Shrier DA and Ward DS. Morphologic changes in the upper airway of children 

during awakening from propofol administration. Anesthesiology. 2002 Mar;96(3):607-11. 

*Liu M, Hu X and Liu J. The effect of hypothermia on isoflurane MAC in children. Anesthesiology 2001; 

94(3): 429-32. 

Lopez-Gil M, Brimacombe J and Keller C. A comparison of four methods for assessing oropharyngeal leak 

pressure with the laryngeal mask airway (LMA) in paediatric patients. Paediatric Anaesthesia 2001; 

11(3): 319-21. 

Marcus RJ and Thompson JP. Anaesthesia for manipulation of forearm fractures in children: A survey of 

current practice. Paediatric Anaesthesia 2000; 10: 273-6. 

Martyn JAJ, Goudsouzian NG, Chang Y, Szyfelbein SK, Schwartz AE and Patel SS. Neuromuscular effects 

of mivacurium in 2- to 12-yr -old children with burn injury. Anesthesiology 2000; 92: 31-7. 

* Meier S, Geiduschek J, Paganoni R, Fuehrmeyer F and Reber A. The effect of chin lift, jaw thrust, and 

continuous positive airway pressure on the size of the glottic opening and on stridor score in 

anesthetized, spontaneously breathing children. Anesthesia and Analgesia 2002; 94(3): 494-9. 

Nesher N, Wolf T, Uretzky G, A Oppenheim-Eden, E Yussim, I Kushnir, G Shoshany, B Rosenburg and 

Berant M. A novel thermoregulatory system maintains perioperative normothermia in children 

undergoing elective surgery. Paediatric Anaesthesia 2001; 11(5): 555-560. 

* Nosovitch MA, Johnson JO, Tobias JD. Noninvasive intraoperative monitoring of carbon dioxide in children: 

endtidal versus transcutaneous techniques. Paediatric Anaesthesia 2002; 12(1): 48-52. 

* Odegard KC, Modest SA and Laussen PC. A survey of parental satisfaction during parent present 

induction of anaesthesia for children undergoing cardiovascular surgery. Paediatric Anaesth. 2002; 

12(3): 261-6. 

Okuda K, Inagawa G, Miwa T and Hiroki K. Influence of head and neck position on cuff position and 

oropharyngeal sealing pressure with the laryngeal mask airway in children. British Journal of 

Anaesthesia 2001; 86(1): 122-124. 


Ozlu O, Turker AK, Ozgun G and Soykan I. Distal oesophageal pH measurement in children during general 

anaesthesia using the laryngeal mask airway, tracheal tube and face mask. Paediatric Anaesthesia 

2001: 11(4): 425-9. 

Parnis SJ, Barker DS and Van Der Walt JH. Clinical predictors of anaesthetic complications in children with 

respiratory tract infections. Paediatric Anaesthesia 2001; 11(1): 29-40. 

Reber A, Paganoni R and Frei FJ. Effect of common airway manoeuvres on upper airway dimensions and 

clinical signs in anaesthetized, spontaneously breathing children. British Journal of Anaesthesia 2001; 

86(2): 217-222. 

Reynolds LM, Infosino A, Brown R, Hsu J and Fisher DM. Pharmacokinetics of rapacuronium in infants and 

children with intravenous and intramuscular administration. Anesthesiology 2000; 92: 376-86. 

Scalfaro P, Sly PD, Sims C and Habre W. Salbutamol prevents the increase in respiratory resistance caused 

by tracheal intubation during sevoflurane anesthesia in asthmatic children. Anesthesia and Analgesia 

2001; 93: 898-902. 

* Simon L, Boucebci KJ, Orliaguet G, Aubineau JV, Devys JM and Dubousset AM. A survey of practice of 

tracheal intubation without muscle relaxant in paediatric patients. Paed. Anaesth. 2002; 12(1): 36-42. 

Soh CR. Laryngeal mask airway insertion in paediatric anaesthesia: comparison between the reverse and 

standard techniques. Anaesthesia and Intensive Care 2001; 29(5): 519-519. 

Splinter W and Isaac LA. The pharmacoeconomics of Neuromuscular blocking drugs: A perioperative cost 

minimization strategy in children. Anesthesia and Analgesia 2001; 93(2): 339-344. 

* Struys MM, Jensen EW, Smith W, Smith NT, Rampil I, Dumortier FJ, Mestach C and Mortier EP. 

Performance of the ARX-derived auditory evoked potential index as an indicator of anesthetic depth: a 

comparison with bispectral index and hemodynamic measures during propofol administration. 

Anesthesiology 2002; 96(4): 803-16. 

Suga A, Tanaka M and Toyooka H. Effects of i.v. metoclopramide, atropine and their combination on gastric 

insufflation in children anaesthetized with sevoflurane and nitrous oxide. Paediatric Anaesthesia 2001; 

11(2): 151-156. 

Tait A, Malviya S, Voepel-Lewis T, Munro H, Siewert M and Pandit UA. Risk Factors for perioperative 

adverse respiratory events in children with upper respiratory tract infections. Anesthesiol. 2001; 95(2): 

299-306. 

Vakkuri A, Yli-Hankala A, Sarkela M, Lindgren L, Mennander S, Korttila K, Saarnivaara L and Jantti V. 

Sevoflurane mask induction of anaesthesia is associated with epileptiform EEG in children. Acta 

Anaesthesiologica Scandinavica 2001; 45(7): 805-11. 

Walpole R, Olday J, Haetzman M, Drummond GB and Doyle E. A comparison of the respiratory effects of 

high concentrations of halothane and sevoflurane. Paediatric Anaesthesia 2001; 11(2): 157-60. 

* Watcha MF. Investigations of the bispectral index monitor in pediatric anesthesia: first things first. 


Wedgewood J and Doyle E. Anaesthesia and laparoscopic surgery in children. Paediatric Anaesthesia 

2001; 11(4): 391-9. (review) 

Woloszczuk-Gebicka B, Lapczynski T and Wierzejski W. The influence of halothane, isoflurane and 

sevoflurane on rocuronium infusion in children. Acta Anaesthesiologica Scandinavica 2001; 45(1): 73- 

7. 

* Yaguchi Y, Inomata S, Kihara S, Baba Y, Kohda Y and Toyooka H. The reduction in minimum alveolar 

concentration for tracheal extubation after clonidine premedication in children. Anesthesia and 

Analgesia 2002; 94(4): 863-6. 

ENT and eyes 

Bowhay AR, May HA, Rudnicka AR and Booker PD. A randomized controlled trial of the antiemetic effect of 

three doses of ondansetron after strabismus surgery in children. Paed. Anaesth. 2001; 11(2): 215-21. 


Duman A, Ogun CO and Okesli S. The effect on intraocular pressure of tracheal intubation or laryngeal 

mask insertion during sevoflurane anaesthesia in children without the use of muscle relaxants. 


Hallen J, Rawal N and Gupta A. Postoperative recovery following outpatient pediatric myringotomy: a 

comparison between sevoflurane and halothane. Journal of Clinical Anesthesiology 2001; 13(3): 161- 

6. 

Handa F and Fujii Y. The efficacy of oral clonidine premedication in the prevention of postoperative vomiting 

in children following strabismus surgery. Paediatric Anaesthesia 2001 11(1): 71-4. 

Jones SE, Dickson U and Moriarty A. Anaesthesia for insertion of bone-anchored hearing aids in children: a 

7-year audit. Anaesthesia 2001 56(8): 777-80. 

Khan FA and Memon GA. Comparison of spontaneous with controlled mode of ventilation in tonsillectomy. 


* Rusy LM, Hoffman GM and Weisman SJ. Electroacupuncture prophylaxis of postoperative nausea and 

vomiting following pediatric tonsillectomy with or without adenoidectomy. Anesthesiol 2002; 96(2): 300- 

5. 

Salonen A, Kokki H and Tuovinen K. IV ketoprofen for analgesia after tonsillectomy: comparison of pre and 

post-operative administration. British Journal of Anaesthesia 2001; 86(3): 377-81. 

Shende D, Bharti N, Kathirvel S and Madan R. Combination of droperidol and ondansetron reduces PONV 

after pediatric strabismus surgery more than single drug therapy. Acta Anaesthesiologica Scandinavica 

2001; 45(6): 756-60. 

Splinter WM. Prevention of vomiting after strabismus surgery in children: dexamethasone alone versus 

dexamethsaone plus low-dose ondansetron. Paediatric Anaesthesia 2001; 11(5): 591- 596. 

* Suresh S, Barcelona SL, Young NM, Seligman I, Heffner CL and Cote CJ. Postoperative pain relief in 

children undergoing tympanomastoid surgery: is a regional block better than opioids? Anesthesia and 

Analgesia 2002; 94(4): 859-62. 

* Verghese ST and Hannallah RS. Pediatric otolaryngologic emergencies. Anesthesiol Clin North America. 

2001; 19(2): 237-56, vi. (review) 

Viitanen H and Annila P. Analgesic efficacy of tramadol 2 mg kg(-1) for paediatric day-case adenoidectomy. 

British Journal of Anaesthesia 2001; 86(4): 572-5. 

Dental surgery 

* Andrzejowski J and Lamb L. The effect of swabs soaked in bupivacaine and epinephrine for pain relief 

following simple dental extractions in children. Anaesthesia. 2002; 57(3): 281-3. 

Arch LM, Humphris GM, Lee GT. Children choosing between general anaesthesia or inhalation sedation for 

dental extractions: the effect on dental anxiety. International J Paediatric Dent. 2001; 11(1): 41-8. 

* Horgesheimer JJ, Pribble CG and Lugo RA. The effect of midazolam premedication on discharge time in 

pediatric patients undergoing general anesthesia for dental restorations. Pediatric Dent. 2001; 23(6): 

491-4. 

Lahoud GY, Averley PA and Hanlon MR. Sevoflurane inhalation conscious sedation for children having 

dental treatment. Anaesthesia 2001; 56(5): 476-80. 

Somri M, Vaida SJ, Sabo E, Yassain G, Gankin I and Gaitini LA. Acupuncture versus ondanserton in the 

prevention of postoperative vomiting. A study of children undergoing dental surgery. Anaesthesia 

2001; 56(10): 927-932. 

* Sullivan DC, Wilson CF and Webb MD. A comparison of two oral ketamine-diazepam regimens for the 

sedation of anxious pediatric dental patients. Pediatric Dent. 2001; 23(3): 223-31. 

Regional anaesthesia, pain and analgesia 


Arana A, Morton NS and Hansen TG. Treatment with paracetamol in infants. 

Scandinavica 2001; 45(1): 20-9. (review) 

Acta Anaesthesiologica 

* Ben-Abraham R, Weinbroum AA, Lotan D, Dagan O, Schreriber-Scheffer R, Mishali D, Harel R, Vishne T, 

Barzilay Z and Paret G. Interleukin-8 secretion following cardiopulmonary bypass in children as a 

marker of early postoperative morbidity. Paediatric Anaesthesia 2002; 12(2): 156-61. 

* Bosenberg A, Thomas J, Lopez T, Lybeck A, Huizar K and Larsson LE. The efficacy of caudal ropivacaine 

1, 2 and 3 mg x l(-1) for postoperative analgesia in children. Paediatric Anaesthesia 2002; 12(1): 53-8. 

Bouwmeester NJ, Anand KJS, van Dijk M, Hop WC, Boomsma F and Tibboel D. Hormonal and metabolic 

stress responses after major surgery in children aged 0-3 years: A double blind, randomized trial 

comparing the effects of continuous versus intermittent morphine. International Journal of Anaesthesia 

2001; 87(3): 390-399 

Breschan C, Krumpholz R, Jost R and Likar R. Intraspinal haematoma following lumbar epidural anaesthesia 

in a neonate. Paediatric Anaesthesia 2001; 11(1): 105-8. 

* Cucchiaro G, De Lagausie P, El-Ghonemi A and Nivoche Y. Single-dose caudal anesthesia for major 

intraabdominal operations in high-risk infants. Anesthesia and Analgesia 2001; 92(6): 1439-41. 

Dalens B, Ecoffey C, Joly A, Giaufre E, Gustafsson U, Huledal G and Larsson LE. Pharmacokinetics and 

analgesic effect of ropivacaine following ilioinguinal/iliohypogastric nerve block in children. Paediatric 

Anaesthesia 2001; 11(4): 415-20. 

* Davidson AJ, Eyres RL and Cole WG. A comparison of prilocaine and lidocaine for intravenous regional 

anaesthesia for forearm fracture reduction in children. Paediatric Anaesthesia 2002; 12(2): 146-50. 

* De Negri P, Ivani G, Visconti C, De Vivo P and Lonnqvist PA. The dose-response relationship for clonidine 

added to a postoperative continuous epidural infusion of ropivacaine in children. Anesthesia and 

Analgesia 2001; 93(1): 71-6. 

* Dsida RM, Wheeler M, Birmingham PK, Wang Z, Heffner CL, Cote CJ and Avram MJ. Age-stratified 

pharmacokinetics of ketorolac tromethamine in pediatric surgical patients. Anesthesia and Analgesia 

2002; 94(2): 266-70. 

Engelhardt T and Crawford M. Sublingual morphine may be a suitable alternative for pain control in children 

in the postoperative period. Paediatric Anaesthesia 2001; 11(1): 81-3. 

* Fanelli G, Casati A, Magistris L, Berti M, Albertin A, Scarioni M and Torri G. Fentanyl does not improve the 

nerve block characteristics of axillary brachial plexus anaesthesia performed with ropivacaine. Acta 

Anaesthesiol Scand. 2001; 45(5): 590-4. 

Grunau RE, Oberlander TF, Whitfield MF, Fitzgerald C and Lee SK. Demographic and therapeutic 

determinants of pain reactivity in very low birth weight neonates at 32 weeks' postconceptional age. 

Pediatrics 2001; 107(1): 105-112. 

* Hager H, Marhofer P, Sitzwohl C, Adler L, Kettner S and Semsroth M. Caudal clonidine prolongs analgesia 

from caudal S(+)-ketamine in children. Anesthesia and Analgesia 2002; 94(5): 1169-72 

Hansen TG, Morton NS, Cullen PM and Watson DG. Plasma concentrations and pharmacokinetics of 

bupivacaine with and without adrenaline following caudal anaesthesia in infants. Acta 

Anaesthesiologica Scandinavica 2001; 45(1): 42-7. 

Hansen TG, Ilett KF, Reid C, Lim SI, Hackett LP and Bergesio R. Caudal ropivacaine in infants: population 

pharmacokinetics and plasma concentrations. Anesthesiology 2001; 94(4): 579-84. 

Hashizume Y, Yamaguchi S, Mishio M, Takiguchi T, Okuda Y and Kitajima T. Pediatric caudal block with 

mepivacaine, bupivacaine or a mixture of both drugs: Requirement for postoperative analgesia and 

plasma concentration of local anesthetics. Journal of Clinical Anesthesia 2001; 13(1): 30-34. 

* Huettemann E, Terborg C, Sakka SG, Petrat G, Schier F and Reinhart K. Preserved CO(2) reactivity and 

increase in middle cerebral arterial blood flow velocity during laparoscopic surgery in children. 



* Inomata S, Tanaka E, Miyabe M, Kakiuchi Y, Nagashima A, Yamasaki Y, Nakayama S, Baba Y, Toyooka H, 

Okuyama K and Kohda Y. Plasma lidocaine concentrations during continuous thoracic epidural 

anesthesia after clonidine premedication in children. Anesthesia and Analgesia 2001; 93(5): 1147-51. 

* Ivani G, DeNegri P, Conio A, Grossetti R, Vitale P, Vercellino C, Gagliardi F, Eksborg S and Lonnqvist PA. 

Comparison of racemic bupivacaine, ropivacaine, and levo-bupivacaine for pediatric caudal anesthesia: 

effects on postoperative analgesia and motor block. Regional Anesthesia and Pain Medicine 2002; 

27(2): 157-61. 

* Karmakar MK, Aun CS, Wong EL, Wong AS, Chan SK and Yeung CK. Ropivacaine undergoes slower 

systemic absorption from the caudal epidural space in children than bupivacaine. Anesthesia and 

Analgesia 2002; 94(2): 259-65. 

Kiffer A, Joly E, Wodey P, Carre C and Ecoffey. The effect of preoperative epidural morphine on 

postoperative analgesia in children. Anesthesia and Analgesia 2001; 93(3): 598-600. 

* Kokki H, Karvinen M and Jekunen A. Pharmacokinetics of a 24-hour intravenous ketoprofen infusion in 

children. Acta Anaesthesiol Scand. 2002; 46(2): 194-8. 

* Kokki H and Salonen A. Comparison of pre and postoperative administration of ketoprofen for analgesia 

after tonsillectomy in children. Paediatric Anaesthesia 2002; 12(2): 162-7. 

* Larousse E, Asehnoune K, Dartayet B, Albaladejo P, Dubousset AM, Gauthier F and Benhamou D. The 

hemodynamic effects of pediatric caudal anesthesia assessed by esophageal Doppler. Anesthesia and 

Analgesia 2002; 94(5): 1165-8. 

* Lim SL, Ng Sb A and Tan GM. Ilioinguinal and iliohypogastric nerve block revisited: single shot versus 

double shot technique for hernia repair in children. Paediatric Anaesthesia 2002; 12(3): 255-60. 

Lovstad RZ and Stoen R. Postoperative epidural analgesia in children after major orthopaedic surgery. A 

randomised study of the effect on PONV of two anaesthetic techniques: low and high dose i.v. fentanyl 

and epidural infusions with and without fentanyl. Acta Anaesthesiologica Scand. 2001; 45(4): 482-488. 

Mahajan R, Batra YK, Grover VK and Kajal J. A comparative study of caudal bupivacaine and midazolambupivacaine 

mixture for post-operative analgesia in children undergoing genitourinary surgery. 

International Journal of Clinical Pharmacology & Therapeutics 2001; 39(3): 116-120. 

* Matsota P, Livanios S and Marinopoulou E. Intercostal nerve block with Bupivacaine for post-thoracotomy 

pain relief in children. European Journal of Pediatric Surgery 2001; 11(4): 219-22. 

McCann ME, Sethna NF, Mazoit J-X, Sakamoto M, Rifai N, Hope T, Sullivan L, Auble SG, Berde CB. The 

pharmacokinetics of epidural ropivacaine in infants and young children. Anesthesia and Analgesia 

2001; 93: 893-7. 

* Maurice SC, O'Donnell JJ and Beattie TF. Emergency analgesia in the paediatric population. Part II 

Pharmacological methods of pain relief. Emergency Med Journal 2002; 19(2): 101-5. (review) 

* Meunier JF, Goujard E, Dubousset AM, Samii K and Mazoit JX. Pharmacokinetics of bupivacaine after 

continuous epidural infusion in infants with and without biliary atresia. Anesthesiol. 2001; 95(1): 87-95. 

Ozcengiz D, Gunduz M, Ozbek H and Isik G. Comparison of caudal morphine and tramadol for 

postoperative pain control in children undergoing inguinal herniorrhaphy. Paediatric Anaesthesia 2001; 

11(4): 459-64. 

Paut C, Calmejane J, Delorme F, Lacroix J and Camboulives M. EMLA vs nitrous oxide for venous 

cannulation in children. Anesthesia and Analgesia 2001; 93(3): 590-593. 

* Roux CL, Lejus C, Surbleb M, Renaudin M, Guillaud C, Windt A, Lasnier B and Pinaud M. Is haemostasis 

biological screening always useful before performing a neuraxial blockade in children? Paediatric 

Anaesthesia 2002; 12(2): 118-23. 

Sage FG, Lloyd-Thomas AR and Howard RF. Paediatric lumbar epidurals: a comparison of 21-G and 23-G 

catheters in patients weighing less than 10 kg. Paediatric Anaesthesia 2000; 10: 279-82. 


* Sciard D, Matuszczak M, Gebhard R, Greger J, Al-Samsam T and Chelly JE. Continuous posterior lumbar 

plexus block for acute postoperative pain control in young children. Anesthesiology 2001; 95(6): 1521- 

3. 

* Senel AC, Akyol A, Dohman D and Solak M. Caudal bupivacaine-tramadol combination for postoperative 

analgesia in pediatric herniorrhaphy. Acta Anaesthesiol Scand. 2001; 45(6): 786-9. 

* Simon MJ, Veering BT, Stienstra R, van Kleef JW and Burm AG. The effects of age on neural blockade 

and hemodynamic changes after epidural anesthesia with ropivacaine. Anesthesia and Analgesia 

2002; 94(5): 1325-30. 

Suraseranivongse S, Santawat U, Kraiprasit K, Petcharatana S, Prakkamodom S and Muntraporn N. Crossvalidation 

of a composite pain scale for preschool children within 24 hours of surgery. International 


Suresh S and Annand KJS. Opioid tolerance in neonates: a state of the art review. Paediatric Anaesthesia 

2001; 11(5) 511-522. 

Taddio A. Pain management for neonatal circumcision. Paediatric Drugs 2001; 3(2):101-11. (review) 

Tobias JD. Brachial plexus anaesthesia in children. Paediatric Anaesthesia 2001; 11(3): 265-75. 

* Tobias JD. Therapeutic applications of regional anaesthesia in paediatric-aged patients. Paediatric 

Anaesthesia 2002; 12(3): 272-7. (review) 

* Uejima T and Suresh S. Is 0.375% bupivacaine safe in caudal anesthesia in neonates and young infants? 

Anesthesia and Analgesia 2002; 94(4): 1041. 

* Uguralp S, Mutus M, Koroglu A, Gurbuz N, Koltuksuz U and Demircan M. Regional anesthesia is a good 

alternative to general anesthesia in pediatric surgery: Experience in 1,554 children. Journal of 

Pediatric Surgery 2002; 37(4): 610-3. 

* Verghese ST, Mostello LA, Patel RI, Kaplan RF and Patel KM. Testing anal sphincter tone predicts the 

effectiveness of caudal analgesia in children. Anesthesia and Analgesia 2002; 94(5): 1161-4. 

William JM, Stoddart PA, Williams SA and Wolf AR. Post-operative recovery after inguinal herniotomy in expremature 

infants:comparison between sevoflurane and spinal anaesthesia. British Journal of 

Anaesthesia 2001; 86(3): 366-71. 

Williams DG, Hatch DJ and Howard RF. Codeine phosphate in paediatric medicine. 


British Journal of 

Wolf AR, Stoddart PA, Murphy PJ and Sasada M. Rapid skin anaesthesia using high velocity lignocaine 

particles: a prospective placebo controlled trial. Archives of Diseases in Childhood 2002; 86(4): 309- 

12. 

Day-Care 

* Elcock DH and Sweeney BP. Sevoflurane vs. isoflurane: a clinical comparison in day surgery. 

Anaesthesia. 2002; 57(1): 52-6. 

Gloor A, Dillier C and Gerber A. Ketamine for short ambulatory procedures in children: an audit. Paediatric 

Anaesthesia 2001; 11(5): 533-540. 

* McHugh GA and Thoms GM. The management of pain following day-case surgery. Anaesthesia 2002; 

57(3): 270-5. 

Oddby E, Englund S and Lonnqvist PA. Postoperative nausea and vomiting in paediatric ambulatory 

surgery: sevoflurane versus spinal anaesthesia with propofol sedation. Paediatric Anaesth. 2001; 

11(3): 337-42. 

Sedation 

Cote CJ. Why we need sedation guidelines [2]. Journal of Pediatrics 2001; 138(3): 447-448. 


* Cote CJ. "Conscious sedation": time for this oxymoron to go away! Journal of Pediatrics 2001; 139(1): 15- 

7; discussion 18-9. 

Green SM, Klooster M, Harris T, Lynch EL and Rothrock SG. Ketamine sedation for pediatric 

gastroenterology procedures. Journal of Pediatric Gastroenterology & Nutrition 2001; 32(1): 26-33. 

Hain RDW and Campbell C. Invasive procedures carried out in conscious children: contrast between North 

American and European paediatric oncology centres. Archives Diseases in Childhood 2001; 85: 12-15. 

* Hoffman GM, Nowakowski R, Troshynski TJ, Berens RJ and Weisman SJ. Risk reduction in pediatric 

procedural sedation by application of an American Academy of Pediatrics/American Society of 

Anesthesiologists process model. Pediatrics 2002; 109(2): 236-43. 

Kanagasundaram SA, Lane LJ, Cavalletto BP, Keneally JP and Cooper MG. Efficacy and safety of nitrous 

oxide in alleviating pain and anxiety during painful procedures. Archives Diseases Child. 2001; 84(6): 

492-5. 

Kennedy RM and Luhmann JD. Pharmacological management of pain and anxiety during emergency 

procedures in children. Paediatric Drugs 2001; 3(5): 337-54. (review) 

* Ljungman G, Gordh T, Sorensen S and Kreuger A. Lumbar puncture in pediatric oncology: conscious 

sedation vs general anesthesia. Med Pediatr Oncol. 2001; 36(3): 372-9. 

* Tobias JD and Berkenbosch JW. Tolerance during sedation in a pediatric ICU patient: effects on the BIS 

monitor. Journal of Clinical Anesthesia 2001; 13(2): 122-4. 

van der Walt JH, Sainsbury DA and Pettifer R. Anaesthesia alert: an integrated, networked, register of 

paediatric anaesthetic problems. Anaesthesia and Intensive Care 2001; 29(2): 113-6. 

Weiss M, Schwarz U, Dillier CM and Gerber AC. Teaching and supervising tracheal intubation in paediatric 

patients using videolaryngoscopy. Paediatric Anaesthesia 2001; 11(3): 343-8. 

* Yagiela JA, Cote CJ, Notterman DA, Karl HW, Weinberg JA and McCloskey C. Adverse sedation events in 

pediatrics. Pediatrics 2001; 107(6): 1494. 

Miscellaneous 

Bingham R. Evidence based paediatric resuscitation. Paediatric Anaesthesia 2001; 11(1): 1-2. 

Carapiet D, Fraser J, Wade A, Buss PW and Bingham R. Changes in paediatric resuscitation knowledge 

among doctors. Archives of Diseases in Childhood 2001; 84(5): 412-4. 

Cox RG, Ewen A and Bart BB. The prone position is associated with a decrease in respiratory system 

compliance in healthy anaesthetized infants. Paediatric Anaesthesia 2001; 11(3): 291-6. 

da Costa VV, Saraiva RA, de Almeida AC, Rodrigues MR, Nunes LG and Ferreira JC. The effect of nitrous 

oxide on the inhibition of somatosensory evoked potentials by sevoflurane in children. Anaesthesia 

2001; 56(3): 202-7. 

* Denham EJ and Nelson RM. Self-determination is not an appropriate model for understanding parental 

permission and child assent. Anesthesia and Analgesia 2002; 94(5): 1049-51. 

Erb TO, Schulman SR and Sugarman J. Permission and assent for clinical research in pediatric anesthesia. 


Edgar J, Morton NS and Pace NA. Review of ethics in paediatric anaesthesia: intensive care issues. 


Edgar J, Morton NS and Pace NA. Review of ethics in paediatric anaesthesia: research issues. Paediatric 


Edgar J, Morton NS and Pace NA. Review of ethics in paediatric anaesthesia: consent issues. Paediatric 



* Fisher QA, Nichols D, Stewart FC, Finley GA, Magee WP Jr and Nelson K. Assessing pediatric anesthesia 

practices for volunteer medical services abroad. Anesthesiol. 2001; 95(6): 1315-22. (see Editorial 1311- 

2) 

Hammer GB, N Funck N, Rosenthal DN and Feinstein JA. A technique for maintenance of airway access in 

infants with a difficult airway following tracheal extubation. Paediatric Anaesthesia 2001; 11(5): 622- 

625 

Hammer GB, Litalieu C, Wellis V and Drover DR. Determination of the median effective concentration (EC 50 ) 

of propofol during oesophagogastroduodenoscopy in children. Paed. Anaesth 2001; 11(5): 549-554. 

Heard CM, Gunnarsson B, Heard AM, Watson E, Orie JD and Fletcher JE. Anaesthetic technique for 

transoesophageal echocardiography in children. Paediatric Anaesthesia 2001; 11(2): 181-4. 

* James I. Cuffed tubes in children. Paediatric Anaesthesia 2001; 11(3): 259-63. 

* Kathirvel S, Dash HH, Bhatia A, Subramaniam B, Prakash A and Shenoy S. Effect of prophylactic 

ondansetron on postoperative nausea and vomiting after elective craniotomy. Journal of Neurosurgery 

and Anesthesiology 2001; 13(3): 207-12. 

* Krauss B. Management of acute pain and anxiety in children undergoing procedures in the emergency 

department. Pediatric Emergency Care 2001; 17(2): 115-22; quiz 123-5. (review) 

* Lee C and Mason LJ. Pediatric cardiac emergencies. Anesthesiol Clin North America 2001; 19(2): 287- 

308. (review) 

* Liu LM and Pang LM. Neonatal surgical emergencies. Anesthesiol Clin North America 2001; 19(2): 265- 

86. (review) 

Rosenstock C, Moller J and Hauberg A. Complaints related to respiratory events in anaesthesia and 

intensive care medicine from 1994 to 1998. Denmark.Acta Anaesthesiologica Scandinavica 2001; 

45(1): 53-8. 

Morgan-Hughes NJ and Kirton CB. EMLA--is one hour long enough? Anaesthesia 2001; 56(5): 495-6. 

Podder S, Dutta A, Yaddanapudi S and Chari P. Challenges in paediatric mask holding; the 'claw hand' 

technique. Anaesthesia 2001; 56(7): 697-9. 

* Ross AK. Pediatric trauma. Anesthesia management. Anesthesiol Clin North America 2001; 19(2): 309- 

37. (review) 

Saghaei M and Razavi S. Bloodletting acupuncture for the prevention of stridor in children after tracheal 

extubation: a randomised, controlled study. Anaesthesia 2001; 56(10): 961-964. 

Schily M, Koumoukelis H, Lerman J and Creighton RE. Can pediatric anesthesiologists detect an occluded 

tracheal tube in neonates? Anesthesia and Analgesia 2001; 93(1): 66-70. 

Sobolev I, Plunkett N and Barker I. Acute epiglottitis, sevoflurane and HIB vaccination. Anaesthesia 2001; 

56(8): 807-8. 

Thomas PB and Parry MG. The difficult paediatric airway: a new method of intubation using the laryngeal 

mask airway TM , Cook airway exchange catheter and tracheal intubation fibrescope. Paediatric 

Anaesthesia 2001; 11(5): 618-621. 

* Tobias JD. Caudal epidural block: a review of test dosing and recognition of systemic injection in children. 

Anesthesia and Analgesia 2001; 93(5): 1156-61. (review) 

* Tobias JD and Burd RS. Anaesthetic management and high frequency oscillatory ventilation. Paediatric 

Anaesthesia 2001; 11(4): 483-7. 

Tong JL and Thomas ML. World Wide Web resources and the paediatric anaesthetist: Surf's up. Paediatric 

Anaesthesia 2001; 11(1): 19-27. 

Watson A and Visram A. Survey of the use of oesophageal and precordial stethoscopes in current paediatric 

anaesthetic practice. Paediatric Anaesthesia 2001; 11(4): 437-42. 


Weiss M, Hartman K, Fischer KE and Gerber A. Use of angulated video-intubation laryngoscope in children 

undergoing manual in-line neck stabilization. International Journal of Anaesthesia 2001; 87(3): 453- 

458. 

Wodey E, Gai V, Carre F and Ecoffey C. Accuracy and limitations of continuous oesophageal aortic blood 

flow measurement during general anaesthesia for children: comparison with transcutaneous 

echography-Doppler. Paediatric Anaesthesia 2001; 11(3): 309-17. 

Zatman TF, Hall JE and Harmer M. Gastric residual volume in children: a study comparing efficiency of 

erythromycin and metoclopramide as prokinetic agents. British Journal Anaesth. 2001; 86(6): 869-71. 

Organisation 

* Davies LK. Con: Anesthetics should be administered to pediatric patients undergoing cardiac surgical 

procedures not only by pediatric anesthesiologists. Journal of Cardiothoracic and Vascular Anesthesia 

2001; 15(3): 384-7. 

* Kahana M. Pro: Only pediatric anesthesiologists should administer anesthetics to pediatric patients 

undergoing cardiac surgical procedures. J Cardiothoracic and Vascular Anesthesia 2001; 15(3): 381-3. 

Kinouchi K and Kitamura S. Improved viability of the low birth weight infant and the increasing needs for 

anaesthesia. Paediatric Anaesthesia 2001; 11(2): 131-3. 

Lauder GR. Delegation in paediatric anaesthesia: a postal survey. Paediatric Anaesth. 2001; 11(3): 349-54. 

Specialist 

* Baum VC. Cardiac trauma in children. Paediatric Anaesthesia 2002; 12(2): 110-7. (review) 

Bengtsson J, Edberg KE, Nilsson B and Bengtson JP. Monitoring of pacemaker induced changes in cardiac 

output with inspired to endtidal oxygen difference in paediatric cardiac surgery patients. Paediatric 

Anaesthesia 2001; 11(2): 191-7. 

Cray SH, Holtby HM, Kartha VM, Cox PN and Roy WL. Early tracheal extubation after paediatric cardiac 

surgery: the use of propofol to supplement low-dose opioid anaesthesia. Paediatric Anaesthesia 2001; 

11(4): 465-71. 

Dahmani S, Orliaguet GA, Meyer PG, Blanot S, Renier D and Carli PA. Perioperative blood salvage during 

surgical correction of craniosynostosis in infants. British Journal of Anaesthesia 2000; 85: 550-55. 

Davis L and Ross N. Bilateral vocal cord palsy after ventricular drainage in a child. 

Analgesia 2001; 92(2): 358-61. 

Anesthesia and 

* De Gabriele LC, Cooper MG, Singh S and Pitkin J. Intraoperative fibreoptic bronchoscopy during neonatal 

ttracheo-oesophageal fistula ligation and oesophageal atresia repair. Anaesthesia and Intensive Care 

2001; 29(3): 284-7. 

Farley-Hills E, Byrne AJ, Brennan L and Sartori P. Tumour lysis syndrome during anaesthesia. Paediatric 

Anaesthesia 2001; 11(2): 233-6. 

* Hain RD and Campbell C. Invasive procedures carried out in conscious children: contrast between North 

American and European paediatric oncology centres. Archives Diseases in Child. 2001; 85(1): 12-5. 

* Hamid RK and Newfield P. Pediatric neuroanesthesia. Neural tube defects. Anesthesiol Clin North 


* Hamid RK and Newfield P. Pediatric neuroanesthesia. Hydrocephalus. Anesthesiol Clin North America 

2001; 19(2): 207-18. (review) 

Hammer GB and Krane EJ. Anaesthesia for liver transplantation in children. Paediatric Anaesthesia 2001; 

11(1): 3-18. 

* Hammer GB. Pediatric thoracic anesthesia. Anesthesia and Analgesia 2001; 92(6): 1449-64. (review) 

Heard CMB, Gunnarsson B, Heard AMB, Watson E, Orie JD and Fletcher JE. Anaesthetic technique for 

transoesophageal echocardiography in children. Paediatric Anaesthesia 2001; 11(2): 181-184. 


* Imanaka H, Nishimura M, Miyano H, Uemura H and Yagihara T. Effect of synchronized intermittent 

mandatory ventilation on respiratory workload in infants after cardiac surgery. Anesthesiology 2001; 

95(4): 881-8. 

* Iohom G and Lyons B. Anaesthesia for children with epidermolysis bullosa: a review of 20 

years'experience. European Journal of Anaesthesiology 2001; 18(11): 745-54. 

* Jayabose S, Levendoglu-Tugal O, Giamelli J, Grodin W, Cohn M, Sandoval C, Ozkaynak F, Kubal K, 

Nosetti M, Uman J and Visintainer P. Intravenous anesthesia with propofol for painful procedures in 

children with cancer. Journal of Pediatric Hematology and Oncology 2001; 23(5): 290-3. 

Keidan I, Berkenstadt H, Sidi A and Perel A. Propofol/remifentanil versus propofol alone for bone marrow 

aspiration in paediatric haemato-oncological patients. Paediatric Anaesthesia 2001; 11(3): 297-301. 

Laussen PC, Murphy JA, Zurakowski D, Sullivan LJ, McGowan FX Jr and DeMaso DR. Bispectral index 

monitoring in children undergoing mild hypothermic cardiopulmonary bypass. Paediatric Anaesthesia 

2001; 11(5): 567- 574. 

* Matsota P, Avgerinopoulou-Vlahou A and Velegrakis D. Anaesthesia for phaeochromocytoma removal in a 

5-year-old boy. Paediatric Anaesthesia 2002; 12(2): 176-80. 

* Mali M, Bagry H and Vas L. Anaesthetic management of a case of nesidioblastosis for subtotal 

pancreatectomy. Paediatric Anaesthesia 2002; 12(1): 80-4. 

Muralidhar K and Shetty DP. Ventilation strategy for video-assisted thoracoscopic clipping of patent ductus 

arteriosus in children. Paediatric Anaesthesia 2001; 11(1): 45-48. 

Nakayama S, Yamashita M, Osaka Y,Isobe T and Izumi H. Right internal jugular vein venography in infants 

and children. Anesthesia and Analgesia 2001; 93(2): 331-334. 

* Newfield P, Hamid RK. Pediatric neuroanesthesia. Arteriovenous malformations. Anesthesiol Clin North 


Orliaguet GA, Hanafi M, Meyer PG, Blanot S, Jarreau MM, Bresson D, Zerah M and Carli PA. Is the sitting or 

the prone position best for surgery for posterior fossa tumours in children ? Paediatric Anaesthesia 

2001; 11(5): 541-548 

Paut O and Bissonnette B. Effect of halothane on the cerebral circulation in young children: a hysteresis 

phenomenon. Anaesthesia. 2001; 56(4): 360-5. 

* Payne D, McKenzie SA, Stacey S, Misra D, Haxby E and Bush A. Safety and ethics of bronchoscopy and 

endobronchial biopsy in difficult asthma. Archives of Diseases in Childhood 2001 84(5): 423-6. 

* Pierson J and Mayhew JF. Anesthesia in a child with Rett syndrome: a case report and literature review. 

AANA J. 2001; 69(5): 395-6. 

* Ravn HB, Hjortdal VE, Stenbog EV, Emmertsen K, Kromann O, Pedersen J and Sorensen KE. Increased 

platelet reactivity and significant changes in coagulation markers after cavopulmonary connection. 

Heart 2001; 85(1): 61-5. 

* Roche J, Frawley G and Heggie A. Difficult tracheal intubation induced by maxillary distraction devices in 

craniosynostosis syndromes. Paediatric Anaesthesia 2002; 12(3): 227-34. 

Rodriguez RA, Cornel G, Weerasena NA, Pham B and Splinter WM. Effect of Trendelenburg head position 

during cardiac deairing on cerebral microemboli in children: A randomized controlled trial. Journal 

Thorac Cardiovasc Surgery 2001; 121(1): 3-9. 

* Schwartz DA, Moriarty KP, Tashjian DB, Wool RS, Parker RK, Markenson GR, Rothstein RW, Shah BL, 

Connelly NR and Courtney RA. Anesthetic management of the exit (ex utero intrapartum treatment) 

procedure. Journal of Clinical Anesthesia 2001; 13(5): 387-91. 

Sonzogni V, Crupi G, Poma R, Annechino F, Ferri F, Filisetti P and Bellavita P. Erythropoietin therapy and 

preoperative autologous blood donation in children undergoing open heart surgery. International 



* Steiner LA, Studer W, Baumgartner ER and Frei FJ. Perioperative management of a child with very-longchain 

acyl-coenzyme A dehydrogenase deficiency. Paediatric Anaesthesia 2002; 12(2): 187-91. 

Suominen P, Palo R, Sairanen H, Olkkola KT and Rasanen J. Perioperative determinants and outcome of 

cardiopulmonary arrest in children after heart surgery. European Journal of Cardiothoracic Surgery 

2001; 19(2): 127-34. 

* Tabbutt S, Ramamoorthy C, Montenegro LM, Durning SM, Kurth CD, Steven JM, Godinez RI, Spray TL, 

Wernovsky G and Nicolson SC. Impact of inspired gas mixtures on preoperative infants with 

hypoplastic left heart syndrome during controlled ventilation. Circulation 2001;18;104(12 Suppl 1):I159- 

64. 

* Tercan E, Sungun MB, Boyaci A and Kucukaydin M. One-lung ventilation of a preterm newborn during 

esophageal atresia and tracheoesophageal fistula repair. Acta Anaesthesiol Scand. 2002; 46(3): 332- 

3. 

Tobias JD. Thoracoscopy in the pediatric patient. Anesthesiology Clinics of North America 2001; 19(1): 

173-186. (review) 

Tobias JD, Gaines RW, Lowry KJ, Kittle D and Bildner C. A dual epidural catheter technique to provide 

analgesia following posterior spinal fusion for scoliosis in children and adolescents. Paediatric 

Anaesthesia 2001; 11(2): 199-203. 

Tobias JD, Johnson JO, Jimenez DF, Barone CM, Scott D and McBride Jr. Venous Air Embolism during 

endoscopic strip craniectomy for repair of craniosynostosis in infants. Anesthesiol. 2001; 95(2): 340-2. 

* Tripi PA, Thomas S and Dearborn DG. Management of general anaesthesia in infants and children with a 

history of idiopathic pulmonary haemorrhage. Paediatric Anaesthesia 2002; 12(3): 243-7. 

Uezono S, Holzman RS, Goto T, Nakata Y, Nagata S and Morita S. Prediction of difficult airway in schoolaged 

patients with microtia. Paediatric Anaesthesia 2001; 11(4): 409-13. 

van der Walt JH and Moran C. An audit of perioperative management of autistic children. 

Anaesthesia 2001; 11(4): 401-8. 

Paediatric 

Vas L, Patil B, Ragavendra S, Hosalkar H and Pratibha G Complications of anaesthesia and surgery for 

laryngotracheo-oesophageal cleft. Paediatric Anaesthesia 2001; 11(3): 361-5. 

Vas L and Sawant P. A review of anaesthetic technique in 15 paediatric patients with temporomandibular 

joint ankylosis. Paediatric Anaesthesia 2001; 11(2): 237-44. 

Wales PW, Carver E, Crawford MW and Kim PC. Acute chest syndrome after abdominal surgery in children 

with sickle cell disease: Is a laparoscopic approach better? J Pediatric Surgery 2001; 36(5): 718-21. 

Wardle SP, Kelsall AWR, Yoxall CW and Subhedar NV. Percutaneous femoral arterial and venous 

catherisation during neonatal intensive care. Arch Dis Child Fetal Neonatal Ed 2001; 85: 119-122. 

* White RJ and Bass S. Anaesthetic management of a patient with myotonic dystrophy. Paediatric 

Anaesthesia 2001; 11(4): 494-7. 

Wilson GA, Brown JL, Crabbe DG, Hinton W, McHugh PJ and Stringer MD. Is epidural analgesia associated 

with an improved outcome following open Nissen’s fundoplication? Paediatric Anaesthesia 2001; 

11(1): 65-70.

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