[Unjustify laparotomy in a thoracoabdominal trauma patient with shock: responsibility and consequences of large volume vascular loading].
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Biomedical subjects
Publications and source records attributed to M Bemer.
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Computed Tomography scans of the head demand a perfect motionless state, requiring sedation or general anesthesia for young children. Taking into account that CT Scan is innocuous, the proposed method of sedation must be devoid of any risk. A study was made about one hundred cases of intramuscular methohexital sedation of children, ages 3 weeks to 6 years (average age 26.05 +/- 19.95 months and average weight 9.9 +/- 4.07 kilograms). Children's medical antecedents were heavy foetal suffering, artificial ventilation at birth time, anticonvulsant medication for thirty percent of children. Average duration of the Scan was 35.8 +/- 12 minutes, with injection of contrast material in 83 percent of children. Injection of iodized material brings on a glow of warmth that can induce withdrawal movements of the child. Contrast material is used at the dose of 2 milliliters per kilogram. In general, CT Scan is performed after a clinical examination of the child, without any premedication. The child receives methohexital saline 2.5 percent solution intramuscularly deep in outer upper quadrant of the buttock, 10 mg per kilogram-1. Once the sedation is obtained, an infusion of isotonic glucose is set on to compensate fasting. The child, spontaneously breathing, is clinically and under ECG monitoring watched over at a distance. At the end of the Scan, children are observed in the recovery ward for 46 +/- 18 minutes before going back to their ward or their parents. Intramuscular methohexital provided adequate sedation to 96 patients. Two cases of failure to achieve a motionless state required general anesthesia induced with halothane.(ABSTRACT TRUNCATED AT 250 WORDS)
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