Recovery from anaesthesia in children

There are no published comprehensive surveys of paediatric recovery room experience and the incidence of complications. A prospective survey was made of 16,700 consecutive admissions to the recovery room at the Royal Manchester Children's Hospital during the years 1985-1988. The incidence of respiratory complications was low, with laryngospasm 0.85%. The incidence of hypotension was higher than that in adult studies; over 50% of children recorded a decrease in blood pressure in the recovery room of more than 20%, compared to values before operation. The incidence of vomiting in the recovery room was also lower than in comparable adult studies. Certain aspects of recovery room practice changed during the 4 years of the study; these included routine oxygen administration, parents in the recovery room, and our approach to postoperative analgesia. The implications of these changes are discussed.     

Premedication for children with oral trimeprazine and droperidol

In 60 children aged 1-9 years, weighing under 33 kg, oral trimeprazine and oral trimeprazine plus droperidol were compared as premedicants in a controlled, double-blind clinical trial. The addition of droperidol to the trimeprazine syrup produces greater uniformity in pre-operative sedation, a low incidence of postoperative vomiting, and a reduced requirement for postoperative analgesia.     

ARE INTRAVENOUS CANNULAE STILL BEING MISUSED?

SUMMARY We have surveyed the use of intravenous cannulae (IVC) in a district general hospital. Of 354 patients interviewed on various wards, 125 (35.3%) had IVC in situ. The wrist was the commonest location for the cannulae (41.6%). An indication for cannula insertion was present in the majority (93.7%) of patients. Cannulae were left in situ even after their use had ceased, most commonly on wards for the elderly, and on these wards complications were more common. Other wards had specific IVC documentation, which resulted in fewer complications. Cannulae should be used for specific indications and should be reviewed daily for the development of complications and the need for their continued presence.     

Who Attends Family Planning Clinics?

Summary: Data were obtained from 1,810 consecutive women who attended a central metropolitan (Brisbane) Family Planning Clinic during a 5 week period in 1982. Young women in particular formed the major client group with 32% being under 20 years of age. The client population was skewed towards women of upper socioeconomic status (SES). There was no SES disproportion in the use of oral contraceptives or IUD's. However, diaphragm use occurred disproportionately in women of upper SES groups; postcoital contraception was sought by and limited to, women of SES classes A and B only. The clinic satisfied a need for women with a history of failed or absent contraception and 15% had already had a termination of pregnancy by the time they first presented at the clinic.     

Hypoxaemia during induction of anaesthesia—an audit of children who underwent general anaesthesia for routine elective surgery

Arterial oxygen saturation was measured using pulse oximetry during induction of anaesthesia in 108 children aged 10 days--14 years. No restriction was placed on the method of induction. Oxygen saturation decreased to less than 90% in 29 children (26.8%) and less than 80% in seven children (6.4%). There was a significantly increased incidence of desaturation (to less than 90%) in children under one year of age, in those who had no premedication, in those who received only atropine as a premidicant and in children who were anxious or crying before intravenous induction. Oxygen saturation did not decrease below 90% in any child who received inhalational induction.