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Biomedical subjects

E Sumner

Publications and source records attributed to E Sumner.

At least 19 recordsLinked to original sources
PubMed1990

Parents and paediatric anaesthesia: a prospective survey of parental attitudes to their presence at induction.

Parental presence at induction of anaesthesia is controversial and of disputed value. Ninety out of 117 parents replied to a preoperative questionnaire designed to identify their preference and motivation with regard to accompanying their children to the anaesthetic room. Half the parents wished to be present at induction, irrespective of the child's age or previous surgical experience and the most commonly cited reasons for this were the child's anxiety or the parents' sense of duty; 32% of these parents changed their preference if their child were to be adequately sedated preoperatively. In addition, 18% of all parents felt that they would prefer not to be present at induction. The results suggest that in circumstances where parents are to be excluded from induction, adequate preoperative explanation and sedative premedication would contribute to allaying parental anxiety, but that a flexible policy may be most appropriate.

Anesthesia↗
PubMed1987

Anaesthesia in the prune-belly syndrome. A review of 36 cases.

Between 1959 and 1984, 36 children with the prune-belly syndrome underwent 133 operations at the Hospital for Sick Children, Great Ormond Street. The anaesthetic and surgical problems have been reviewed. Minor postoperative respiratory tract infections followed eight anaesthetics. Three deaths occurred in the postoperative period. In two of these there were multifactorial causes, not directly related to the prune-belly syndrome. One death was related to the sequelae of the syndrome. Normal doses of muscle relaxants are recommended when intermittent positive pressure ventilation is used during anaesthesia. Monitoring of the patient's respiratory state and active physiotherapy are advisable postoperatively. Analgesics should be used with caution.

Anesthesia, General↗
PubMed1987

The use of opioids in neonates. A retrospective study of 933 cases.

This is a retrospective study on the use of postoperative opioids in neonates admitted to the surgical intensive care unit at Great Ormond Street over a 5-year period (1980-84). A total of 131 (14%) babies received opioids out of 933 neonates admitted to the unit. The use of opioids increased from 9.7% to 27.2% of admitted cases during the survey period. Postoperative ventilation of the lungs was necessary in 240 (25.7%) cases and 88 (36.6%) of these were given opioids. Four babies initially failed to wean from controlled ventilation as a result of opioid induced respiratory depression. A total of 51 (7.35%) spontaneously breathing neonates received opioids and seven (13.7%) of these developed apnoea or respiratory failure thought to be induced by opioids. The administration of opioids by nurses occurred most frequently in the late evening and early hours of the morning, when medical cover is at its lowest level.

Critical Care↗
PubMed1986

Neonatal tracheal perforation. A complication of tracheal intubation.

Tracheal perforation following intubation in the neonatal period is rarely reported but is a serious complication that should be considered whenever difficulty in ventilation, surgical emphysema or pneumothoraces appear following intubation. Management includes the immediate and skilled replacement of the tube within the tracheal lumen and control of the air leak. Factors which increase the likelihood of occurrence of perforation are discussed.

Humans↗
PubMed1986

Respiratory disturbance and posterior fossa surgery. A case report.

This report, of a 16-month-old child recovering from surgery for a posterior fossa tumour, illustrates how pneumotachography, capnography and occlusion testing before and during CO2 challenge can be of clinical value in the analysis of a difficult respiratory disturbance in the early postoperative period. The application of these techniques to assist decisions regarding timing of extubation as well as for assessment of the influence of remaining tumour on respiratory competence is discussed.

Brain Neoplasms↗
PubMed1986

Halothane hepatitis in an 11-month-old child.

Halothane hepatitis is extremely rare in childhood. However, this occurred in an 11-month-old infant, following multiple exposure to halothane. The diagnosis was confirmed by detection of specific antibodies to halothane-sensitised rabbit hepatocytes. The anaesthetic technique for a subsequent procedure with a halothane-free breathing system is also outlined.

Anesthesia, Inhalation↗
PubMed1984

Late perforation by central venous cannulae.

Three cases of hydrothorax secondary to late perforation of the superior vena cava by central venous cannulae are presented. The care of central venous cannulae is discussed.

Catheterization↗
PubMed1982

Improved prognosis in congenital diaphragmatic hernia: experience of 62 cases over 2-year period.

During 1979 and 1980, 62 babies with congenital diaphragmatic hernia were admitted to the Hospitals for Sick Children. All 62 babies underwent surgical closure of the anatomical defect. There were 44 survivors and 18 deaths, a survival rate of 71%. Both the number treated and the overall survival rate were greater than any series reported for a similar period. The number of admissions may reflect earlier diagnosis and improved resuscitation, with safer and more rapid transfer to our units. The improved survival must be mainly attributed to our experience over the past few years which has consolidated understanding and methods of management and led to a close cooperation between surgeon and anaesthetist both in immediate management and in postoperative care.

Female↗