PubMed Health⌕ Search

Biomedical subjects

D Blanco

Publications and source records attributed to D Blanco.

40 records · Page 3Linked to original sources
PubMedDate not supplied

[Propofol: ED50 and ED90 induction doses in pediatric anesthesia].

OBJECTIVE: To study ED50 and ED90 induction doses of propofol in children. PATIENTS AND METHODS: Seventy-two children from 1 to 110 months of age and premedicated with pentobarbital 4 mg/kg participated in the study. Seven different doses of propofol (1.5, 2, 2.5, 3, 3.5, 4 and 4.5 mg/kg) were injected into the dorsal hand or foot vein in 30 seconds. We measured the response to application of the mask, corneal reflex and response to trapezius muscle compression 30 and 60 s after administration. A log-probit statistical analysis was used and complications were noted. RESULTS: The doses that produced 50% elimination of reflexes (ED50) or 90% elimination (ED90) in our patients were 1.74 and 3.95 mg/kg for response to mask; 2.47 and 4.26 mg/kg for elimination of corneal reflex; and 3.27 and 4.79 mg/kg for compression of trapezius. Frequency of pain upon injection was 74% and that of spontaneous movement was 12%. Apnea (breathing halted for longer than 20 s) occurred in 7% of our patients. We recorded no cases of broncho or laryngeal spasm, or skin rash. CONCLUSIONS: Induction with propofol is appropriate given the rarity of stimulant effects, but there is a high frequency of pain upon injection, limiting the usefulness of this drug for anesthetic induction in pediatrics. ED50 and ED90 varies depending on the stimulus assessed.

Age Factors↗
PubMedDate not supplied

Spread of local anesthetic into the epidural caudal space for two rates of injection in children.

BACKGROUND AND OBJECTIVES: The optimal rate of injection of local anesthetic in pediatric caudal blocks has not been determined. The purpose of this study was to determine the influence of two rates of injection on the level of analgesia in children. METHODS: The patients, 79 children, American Society of Anesthesiologists class 1, who were scheduled for minor surgery, were allocated to three groups according to age: group 1, 0-12 months; group 2, 13-36 months; and group 3, 37-72 months. Each age group was further divided randomly into two subgroups according to rate of injection: subgroup A received 1 mL/kg of 0.25% bupivacaine with 1:200,000 epinephrine at a rate of 1 mL/s, and subgroup B received the same dose at a slower rate of 1 mL per 10 s. Level of analgesia was assessed by loss of sensation to skin pinching. Age, weight, height, time of surgery, onset, and level of analgesia and complications were recorded. RESULTS: For the faster rate, significant differences in level of analgesia were found between groups 1 and 2; the groups were not significantly different for the slower rate, however. The median level in patients 12 months and under was two dermatomes above that of patients older than 12 months at both rates. The levels for each rate (subgroups A and B) were not significantly different in any age group. The time needed to reach the highest level became progressively longer with age (from group 1 to 3), and differences were significant at both rates. CONCLUSIONS: Level of analgesia is not affected by the rate injection of 0.25% bupivacaine into the epidural caudal space in children. The time needed to reach the highest level increases as the child ages.

Anesthesia, Epidural↗