Pediatric AnesthesiaVolume 23, Issue 7 p. 667-669 Vignette Alan Conn; his role in the development of the Anesthesia Department at Toronto SickKids Robert E. Creighton, Robert E. Creighton (Formerly) Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario, CanadaSearch for more papers by this authorIan A. Jeremy Sloan, Ian A. Jeremy Sloan (Formerly) Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario, CanadaSearch for more papers by this authorDavid J. Steward, Corresponding Author David J. Steward (Formerly) Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario, Canada Correspondence David J. Steward, Honorary Professor of Anesthesia, University of British Columbia, Vancouver, BC, Canada V6T 1Z1 Email: [email protected]Search for more papers by this author Robert E. Creighton, Robert E. Creighton (Formerly) Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario, CanadaSearch for more papers by this authorIan A. Jeremy Sloan, Ian A. Jeremy Sloan (Formerly) Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario, CanadaSearch for more papers by this authorDavid J. Steward, Corresponding Author David J. Steward (Formerly) Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario, Canada Correspondence David J. Steward, Honorary Professor of Anesthesia, University of British Columbia, Vancouver, BC, Canada V6T 1Z1 Email: [email protected]Search for more papers by this author First published: 23 May 2013 https://doi.org/10.1111/pan.12189Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume23, Issue7Special Issue: Special Themed Issue on Quality ImprovementJuly 2013Pages 667-669 RelatedInformation

To determine whether the incidence of masseter muscle rigidity is affected by the anaesthetic induction sequence, we prospectively studied for ten months the anaesthetic course in 5,641 infants and children who received muscle relaxation to facilitate tracheal intubation. The anaesthetic induction sequence consisted of intravenous sodium thiopentone (STP) 5 mg.kg-1 alone, halothane induction alone 1-4%, or halothane followed by STP. Inhalational inductions with halothane included nitrous oxide and oxygen. Tracheal intubation was facilitated by either intravenous succinylcholine (Sch) at least 1.5 mg.kg-1 or by a non-depolarizing muscle relaxant. The induction sequence and all episodes of MMR were recorded. Ninety percent of the patients received Sch and 10% received a non-depolarising agent. Of those who received Sch, 88% (5,064 patients) were anaesthetised with STP and 12% (607 patients) were anaesthetised with halothane alone or halothane followed by STP. Masseter muscle rigidity was defined clinically by the transient inability to distract the mandible from the maxilla such that the mouth could not be opened or could only be opened with force. No children anaesthetised with STP followed by Sch developed MMR. One child (0.9%) developed MMR after halothane and Sch and two developed MMR after halothane, STP and Sch (0.4%). The incidence of MMR after Sch was less with STP than with halothane alone or with halothane and STP (P < 0.025). The peak CPK values in the three children who developed MMR were 17,580 IU.L-1 after halothane and Sch, and 7,280 IU.-1 and 3,273 IU.-1 after halothane, STP and Sch. There was no evidence of MH reactions in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Pediatric AnesthesiaVolume 3, Issue 5 p. 273-274 Training in paediatric anaesthesia in Canada ROBERT E. CREIGHTON MD, FRCPC, Corresponding Author ROBERT E. CREIGHTON MD, FRCPC The Hospital for Sick Children, Toronto, CanadaDr Robert E. Creighton, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.Search for more papers by this author ROBERT E. CREIGHTON MD, FRCPC, Corresponding Author ROBERT E. CREIGHTON MD, FRCPC The Hospital for Sick Children, Toronto, CanadaDr Robert E. Creighton, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.Search for more papers by this author First published: September 1993 https://doi.org/10.1111/j.1460-9592.1993.tb00085.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume3, Issue5September 1993Pages 273-274 RelatedInformation

To determine the accuracy of end-tidal PCO2 (PETCO2) measurements analyzed with a sidestream capnometer in infants and children whose lungs were ventilated with a Sechrist infant ventilator and an Ayre’s t-piece, we compared PETCO2 measurements obtained from the proximal (PeiCO2-p) and distal (PETCO2-d) ends of the tracheal tube to arterial PCO2 (PaCO2) in 37 healthy infants and children between 1.3 and 24.5 kg. Both PETCO2-p and PETCO2-d accurately approximated PaCO2, however, the mean (± SD) arterial to end-tidal PCO2 difference (Δ(a-ET)PCO2) was significantly greater with proximal (1.27 ± 1.54 mmHg) than with distal sampling (0.64 ± 1.64 mmHg) (P < 0.01). In the subgroup of patients who weighed < 12 kg, the Δ(a-ET)PCO2 using proximal gas sampling (1.94 ± 1.29 mmHg) was also significantly greater than it was using distal sampling (0.74 ± 1.31 mmHg) (P < 0.001). We conclude that although statistically different, both proximal and distal estimates of PETCO2 provide acceptable estimates of PaCO2 in healthy infants and children who are ventilated with a Sechrist infant ventilator and an Ayre’s t-piece system.

To determine the fresh gas flow (FGF) requirements in paediatric patients, we measured the FGFs needed to maintain distal end-tidal PCO2 (PETCO2) values at 30 and 38 mmHg in patients weighing between 3.8 and 20 kg ventilated with either a Sechrist Infant Ventilator IV-100B or an Air-Shields Ventimeter and a Mapleson D circuit. The FGF requirement was 500 ml.kg-1.min-1 to maintain a PETCO2 of 30 mmHg and 250 ml.kg-1.min-1 to maintain a PETCO2 of 38 mmHg when minute ventilation greater than or equal to FGF. When these formulae were used in a subsequent group of similar patients, a wide variation in PETCO2 measurements were obtained. We conclude that the safest and most accurate approach to determine the FGF requirement of paediatric patients is to continuously monitor the PETCO2 in each patient and to adjust the FGF accordingly.

GRAY, I. G.; MITRA, S. K.; NISBET, H. I.; ASPIN, N.; CREIGHTON, R. E. Author Information

On a mesuré le débit sanguin cérébral chez le chien anesthésié au méthoxyflurane avant, pendant et après l'induction d'une hypoxémie artérielle prononcée.